Cold infusions alone are effective for induction of therapeutic hypothermia but do not keep patients cool after cardiac arrest

Kliegel, Andreas; Janata, Andreas; Wandaller, Cosima; Uray, Thomas; Spiel, Alexander; Losert, Heidrun; Kliegel, Matthias; Hölzer, Michael; Haugk, Moritz; Sterz, Fritz; Laggner, Anton N.

doi:10.1016/j.resuscitation.2006.08.023

Cited by 147 publications

(75 citation statements)

References 13 publications

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“…For example, the immediate use of ice-cold intravenous saline to induce TH has been shown to be feasible and can achieve target temperatures (32-34°C) within 60 min. 23,24 It is possible that the use of newer devices and adjunctive use of cold saline might allow for partial cooling to be achieved in an even shorter time frame. In addition, while a number of groups have demonstrated the value of the mouse model of cardiac arrest to evaluate post-resuscitation injury, 25-27 further work in larger animal models will be required.…”

Section: Discussionmentioning

confidence: 99%

Intra-arrest cooling with delayed reperfusion yields higher survival than earlier normothermic resuscitation in a mouse model of cardiac arrest

Zhao¹,

Abella²,

Beiser³

et al. 2008

Resuscitation

103

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SummaryBackground-Therapeutic hypothermia (TH) represents an important method to attenuate postresuscitation injury after cardiac arrest. Laboratory investigations have suggested that induction of hypothermia before return of spontaneous circulation (ROSC) may confer the greatest benefit. We hypothesized that a short delay in resuscitation to induce hypothermia before ROSC, even at the expense of more prolonged ischemia, may yield both physiological and survival advantages.

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Section: Discussionmentioning

confidence: 99%

Intra-arrest cooling with delayed reperfusion yields higher survival than earlier normothermic resuscitation in a mouse model of cardiac arrest

Zhao¹,

Abella²,

Beiser³

et al. 2008

Resuscitation

103

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“…[1][2][3][4][5][6][7] If induction of therapeutic hypothermia using chilled saline is to become a standard practice, then identifying a practical technique that will allow fluid to be infused closest to its initial refrigerator temperature is important. Therefore, the efficiency of infusion techniques should be measured and tested.…”

mentioning

confidence: 99%

Assessing the Influence of Insulation on Intravenous Fluid Infusion Temperature

Studnek

Watts

Vandeventer

et al. 2012

Academic Emergency Medicine

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Objectives: Inducing therapeutic hypothermia using chilled saline in resuscitated cardiac arrest patients has been shown to be feasible and effective. Limited research exists assessing the efficiency of this cooling method. The objective of this study was to assess the change in temperature of 4°C saline upon exiting an infusion set in the laboratory setting while varying conditions of fluid delivery.Methods: Efficiency was studied by assessing change in fluid temperature (°C) during the infusion under four laboratory conditions. Each condition was performed four times using 1-L bags of normal saline. Fluid was infused into a 1000-mL beaker through 10 gtt/mL tubing. Flow rate was controlled using a tubing clamp and in-line transducer with a flow meter, while temperature was continuously monitored in a side port at the terminal end of the intravenous (IV) tubing using a digital thermometer. The four conditions included different insulation methods. Descriptive statistics and analysis of variance were performed to assess changes in fluid temperature.Results: The mean (±SD) fluid temperature at time 0 was 3.2°C (95% confidence interval [CI] = 3.0 to 3.4°C) with no significant difference in starting temperature between groups (p = 0.45). When flow rate was constant, it was determined that fluid temperatures were significantly cooler when infused using a chilled, gel-filled sleeve around the saline bag (p < 0.006). Conclusions:In a laboratory setting, the most efficient method of infusing cold fluid appears to be a method that both keeps the bag of fluid insulated and infused at a faster rate.ACADEMIC EMERGENCY MEDICINE 2012; 19:1309-1312 © 2012 by the Society for Academic Emergency Medicine S everal studies have investigated the effectiveness of chilled saline for the induction of therapeutic hypothermia; however, there is scant research describing the most efficient method for delivering chilled saline. [1][2][3][4][5][6][7] If induction of therapeutic hypothermia using chilled saline is to become a standard practice, then identifying a practical technique that will allow fluid to be infused closest to its initial refrigerator temperature is important. Therefore, the efficiency of infusion techniques should be measured and tested. The objective of this study was to assess the change in temperature of chilled saline upon exiting an infusion set in the laboratory setting while varying certain conditions. It was hypothesized that fluid temperature exiting an infusion set would vary dependent on insulation of the saline bag and infusion set.

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“…Cold infusions are a feasible and safe way to initiate therapeutic hypothermia, but for maintenance additional cooling systems are needed (Kliegel et al 2007). External cooling methods, ice packs and cold-air blankets, ice-water blankets and closed loop intravenous cooling catheters have been used to maintain therapeutic hypothermia (Merchant et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

Virkkunen¹

2009

Acta Anaesthesiol Scand

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Cold infusions alone are effective for induction of therapeutic hypothermia but do not keep patients cool after cardiac arrest

Cited by 147 publications

References 13 publications

Intra-arrest cooling with delayed reperfusion yields higher survival than earlier normothermic resuscitation in a mouse model of cardiac arrest

Intra-arrest cooling with delayed reperfusion yields higher survival than earlier normothermic resuscitation in a mouse model of cardiac arrest

Assessing the Influence of Insulation on Intravenous Fluid Infusion Temperature

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

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