Does induced hypothermia (33°C during the first 24 hours) improve neurologic outcomes in patients with cardiac arrest and non-shockable rhythm?

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Why is this study important?

Resuscitation guidelines recommend targeted temperature management (TTM) with induced hypothermia for all patients with coma after successful resuscitation from cardiac arrest regardless of cardiac rhythm.[1] To date, studies of TTM for patients with nonshockable rhythm (asystole or pulseless electrical activity) have yielded conflicting results yet nonshockable rhythms are the most common among all cardiac arrest patients, and also have the poorest outcomes.[2] This study, the HYPERION trial, compares therapeutic hypothermia with normothermia in cardiac arrest patients with non-shockable rhythms.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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