Cold simple intravenous infusions preceding special endovascular cooling for faster induction of mild hypothermia after cardiac arrest—a feasibility study

Kliegel, Andreas; Losert, Heidrun; Sterz, Fritz; Kliegel, Matthias; Hölzer, Michael; Uray, Thomas; Domanovits, Hans

doi:10.1016/j.resuscitation.2004.09.002

Cited by 166 publications

(79 citation statements)

References 24 publications

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“…Using the same background, the International Liaison Committee on Resuscitation (ILCOR) issued an advisory statement (4) strongly encouraging the use of TH, also in patients with non-VF as initial rhythm. Different cooling methods and devices are available (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Still, TH has not been accepted as standard therapy (16)(17)(18)(19).…”

mentioning

confidence: 99%

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Busch

Søreide

Lossius

et al. 2006

Acta Anaesthesiol Scand

149

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Background: The implementation of therapeutic hypothermia (TH) into daily clinical practice appears to be slow. We present our experiences with rapid implementation of a simple protocol for TH in comatose out-of-hospital cardiac arrest (OHCA) survivors. Methods: From June 2002, we started cooling pre-hospitally with sport ice packs in the groin and over the neck. In the intensive care unit (ICU), we used ice-water soaked towels over the torso. All patients were endotracheally intubated, on mechanical ventilation and sedated and paralysed. The target temperature was 33 AE 1 8C to be maintained for 12-24 h. We used simple inclusion criteria: (i) no response to verbal command during the ambulance transport independent of initial rhythm and cause of CA; (ii) age 18-80 years; and (iii) absence of cardiogenic shock (SBP < 90 mmHg despite vasopressors). We compared the first 27 comatose survivors with a presumed cardiac origin of their OHCA with 34 historic controls treated just before implementation. Results: TH was initiated in all 27 eligible patients. The target temperature was reached in 24 patients (89% success rate). ICUand hospital-length of stay did not differ significantly before and after implementation of TH. Hypokalemia (P ¼ 0.001) and insulin

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mentioning

confidence: 99%

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Busch

Søreide

Lossius

et al. 2006

Acta Anaesthesiol Scand

149

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“…They have been shown to be effective in inducing hypothermia but not in maintenance [36]. Also they can be used with other cooling methods [37]. But most important disadvantage of these systems is the uncontrolled cooling which may result in body temperatures below target range.…”

Section: Conventional Cooling Systemsmentioning

confidence: 99%

“…Venoarterial systems support heart and lung, venovenous systems support lung during ECMO. ECCOR (venovenous, lower blood flow rates system with or without pump) supports only lung 41 [36][37][38][39][40][41][42][43][44][45][46][47][48] ECCOR is provided to remove CO 2 and, unlike ECMO, does not provide significant oxygenation. In contrast to ECMO, where the need for oxygenation requires high blood flow rates, ECCOR allows much lower blood flow rates (500-1000mL/min) and needs smaller access cannulas.…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

“…In conclusion, experience with ECMO has been 43 Karakurt et [36][37][38][39][40][41][42][43][44][45][46][47][48] improving with better survival rates and decreasing morbidity. Considering ECMO for patients with respiratory failure or heart failure when conventional therapies failed, if the underlying pathology is reversible or as a bridge to heart and/or lung transplantation is important.…”

Section: Prognosismentioning

confidence: 99%

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Improvements in intensive care units

Karakurt¹,

Yalçin²,

Arıkan³

2016

MMJ

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We have had some important improvements in the intensive care units (ICU) like high flow oxygen system (HFOS), therapeutic hypothermia, extra corporeal membrane oxygenation (ECMO), extra corporeal carbon dioxide removal (ECCOR), echocardiography (ECHO) and ultrasonography (US).HFOS gives oxygen to the patients at rates of flow higher (up to 60 L/min) than that delivered traditionally in LFOS (up to 16L/ min). It is obtained 1 cmH2O PEEP for every 10L/min of flow delivered by HFOS. HFOS serves as an important alternative to noninvasive mechanical ventilation especially in the management of the patients with hypoxemic respiratory failure.Post-resuscitation care consists of optimization of oxygenation and ventilation, avoiding hypotension, treating immediate precipitants of cardiac arrest such as acute coronary ischemia and initiating therapeutic (induced) hypothermia. Therapeutic hypothermia decreases cerebral metabolic rate, blood volume, and intracranial pressure, prevents reperfusion injury. So hypotermia protects cerebral functions.ECMO, the type of cardiopulmonary support, has become an essential tool in critical care patients with severe respiratory and cardiac failure, refractory to conventional therapy methods.Critical care ultrasonography (CCUS) and echocardiography have utility for intensivist-performed, immediate diagnoses of life threatening diseases, with no need to transport patients to radiology or cardiology departments or wait for radiologist or cardiologist on a consultative basis. CCUS and echocardiography should be an essential part of training of every ICU physician.

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“…Für die Kühlung stehen externe und interne Techniken zur Verfügung [370,371,372]. Muskelzittern kann durch tiefe Sedierung und Relaxierung verhindert werden.…”

Section: Kontrolle Und Management Der Körpertemperaturunclassified