Cardiac arrest outcomes after targeted temperature management with an esophageal cooling device

Abstract

Objective: To assess the efficacy of an esophageal device to provide TTM (Target Temperature Management) post Cardiac Arrest. Design: A chart review of all patients treated with ETTM, following cardiac arrest. Initial patient temperature, time to target, supplemental methods (water blankets, head wraps, or ice packs), and patient survival were extracted for analysis. Setting: Community Medical Center Intensive Care Unit. Patients: All patients receiving TTM via an esophageal device post Cardiac Arrest from August 2016 to November 2018. Interventions: TTM both cooling and warming via an esophageal device. Measurements and Results: A total of 54 patients were treated from August 2016 to November 2018; 30 received ETM only, 22 received supplemental cooling, and 2 had treatment discontinued prior to reaching target due to recovery. Target temperatures ranged from 32 to 36 degrees. The median time to target temperature for the entire cohort was 219 minutes (IQR 81-415). For the cohorts without, and with, supplemental cooling modalities, the median time to attain target temperature was 128 minutes (IQR 71-334), and 285 minutes (IQR 204-660), respectively. Survival to ICU discharge was 51.9% for the entire cohort. Conclusions: ETM attains target temperature at a rate consistent with current guidelines and with similar performance to alternative modalities. This may provide a more cost-effective and approachable core cooling option to community hospitals that only use water blankets or other surface methods.