Therapeutic hypothermia after cardiopulmonary resuscitation - pro and con

After successful cardiopulmonary resuscitation (CPR), mild therapeutic hypothermia remains the only intervention with a fair evidence of improving outcomes. Randomized controlled trials reported a clinically important benefit, at least for selected victims of cardiac arrest. Therapeutic cooling was associated with higher rates of survival without severe neurological impairment, by 15 absolute percent as compared to controls. Among those delivering acute and intensive care, three of four remain sceptical or do not use therapeutic hypothermia. Is this reluctance justified?