Implementation of pre-hospital therapeutic hypothermia in post-cardiac arrest patients in the Czech Republic

Škulec, Roman; Truhlář, Anatolij; Šeblová, Jana; Knor, Jiří; Klementová, Olga; Smržová, Eva; Callerova, Jitka; Dostál, Pavel; Černý, Vladimír

doi:10.1016/j.resuscitation.2011.10.005

Cited by 4 publications

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“…The Czech experience also suggests that implementation of TH benefited from issuing a national consensus statement on TH, dissemination of ready-to-use TH protocols, and undertaking research projects related to TH. The rate of TH use was higher in units admitting more that 10 patients after a cardiac arrest annually [6,14].…”

Section: Discussionmentioning

confidence: 98%

“…For example, wide implementation of TH in the United Kingdom (an increase in the rate of TH use from 28% to 85.6% of patients after cardiac arrest) took place within only about 5 years [4]. Improved implementation of TH may also be related with prehospital use of this treatment approach: in some areas of the Czech Republic, up to 70% of centres have been reported to initiate TH during prehospital phase [14].…”

Section: Discussionmentioning

confidence: 99%

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Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland

et al. 2013

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland

et al. 2013

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“…Financial restrictions were raised by 17% of centers, which is comparable to that reported by other European countries, i.e., Austria and the Czech Republic. 16,17 However, given that the reimbursement of therapeutic hypothermia is available to each and every CICU, and there are flexible modes for renting the TH equipment, this problem is probably more an issue of local awareness than actual financial constraints. In fact, access to the equipment is not per- …”

Section: Discussionmentioning

confidence: 99%

Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland

et al. 2017

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“…The technique of large-volume cold intravenous infusion has been found to be a simple, efficient and safe method of inducing therapeutic hypothermia (TH) in cardiac arrest survivors [ 1 , 2 ], therefore, it has been widely adopted [ 1 , 3 ]. However, in many patients, it fails to achieve target body temperature of 34°C [ 1 , 4 - 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of cold crystalloid and colloid infusions for induction of therapeutic hypothermia in a porcine model of cardiac arrest

et al. 2013

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IntroductionLarge-volume cold intravenous infusion of crystalloids has been used for induction of therapeutic hypothermia after cardiac arrest. However, the effectiveness of cold colloids has not been evaluated. Therefore, we performed an experimental study to investigate the cooling effect of cold normal saline compared to colloid solution in a porcine model of ventricular fibrillation.MethodsVentricular fibrillation was induced for 15 minutes in 22 anesthetized domestic pigs. After spontaneous circulation was restored, the animals were randomized to receive either 45 ml/kg of 1°C cold normal saline (Group A, 9 animals); or 45 ml/kg of 1°C cold colloid solution (Voluven®, 6% hydroxyethyl starch 130/0.4 in 0.9% NaCl) during 20 minutes (Group B, 9 animals); or to undergo no cooling intervention (Group C, 4 animals). Then, the animals were observed for 90 minutes. Cerebral, rectal, intramuscular, pulmonary artery, and subcutaneous fat body temperatures (BT) were recorded. In the mechanical ex-vivo sub study we added a same amount of cold normal saline or colloid into the bath of normal saline and calculated the area under the curve (AUC) for induced temperature changes.ResultsAnimals treated with cold fluids achieved a significant decrease of BT at all measurement sites, whereas there was a consistent significant spontaneous increase in group C. At the time of completion of infusion, greater decrease in pulmonary artery BT and cerebral BT in group A compared to group B was detected (−2.1 ± 0.3 vs. -1.6 ± 0.2°C, and −1.7 ± 0.4 vs. -1.1 ± 0.3°C, p < 0.05, respectively). AUC analysis of the decrease of cerebral BT revealed a more vigorous cooling effect in group A compared to group B (−91 ± 22 vs. -68 ± 23°C/min, p = 0.046). In the mechanical sub study, AUC analysis of the induced temperature decrease of cooled solution revealed that addition of normal saline led to more intense cooling than colloid solution (−7155 ± 647 vs. -5733 ± 636°C/min, p = 0.008).ConclusionsIntravenous infusion of cold normal saline resulted in more intense decrease of cerebral and pulmonary artery BT than colloid infusion in this porcine model of cardiac arrest. This difference is at least partially related to the various specific heat capacities of the coolants.

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Implementation of pre-hospital therapeutic hypothermia in post-cardiac arrest patients in the Czech Republic

Cited by 4 publications

References 4 publications

Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland

Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland

Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland

Comparison of cold crystalloid and colloid infusions for induction of therapeutic hypothermia in a porcine model of cardiac arrest

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