A Bayesian Interpretation of a Pediatric Cardiac Arrest Trial (THAPCA-OH).

Harhay, Michael O; Blette, Bryan S; Granholm, Anders; Moler, Frank W; Zampieri, Fernando G; Goligher, Ewan C; Gardner, Monique M; Topjian, Alexis A et al. · NEJM Evid · 2023

rct · Level II

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Abstract

BACKGROUND: Pediatric out-of-hospital cardiac arrest results in high morbidity and mortality. Currently, there are no recommended therapies beyond supportive care. The THAPCA-OH (Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital) trial compared hypothermia (33.0°C) with normothermia (36.8°C) in 295 children. Good neurobehavioral outcome and survival at 1 year were higher in the hypothermia group (20 vs. 12% and 38 vs. 29%, respectively). These differences did not meet the planned statistical threshold of P75% for all informative prior integrations with the THAPCA-OH results, except those with the most pessimistic priors. CONCLUSIONS: There is a high probability that hypothermia provides a modest benefit in neurobehavioral outcome and survival at 1 year. (ClinicalTrials.gov number, NCT00878644.)

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