Induction of therapeutic hypothermia during prehospital CPR using ice-cold intravenous fluid

Kämäräinen, Antti; Virkkunen, Ilkka; Tenhunen, Jyrki; Yli‐Hankala, Arvi; Silfvast, Tom

doi:10.1016/j.resuscitation.2008.07.003

Cited by 66 publications

(38 citation statements)

References 31 publications

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“…21 Preliminary clinical studies of cooling with LVICF during CPR have been reported recently, although patient numbers in these studies have been too small to demonstrate that this approach improves outcomes. 22,23 Nevertheless, we would propose that future studies enroll patients during CPR to ascertain whether cooling during this phase is associated with improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

et al. 2010

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Background— Therapeutic hypothermia is recommended for the treatment of neurological injury after resuscitation from out-of-hospital cardiac arrest. Laboratory studies have suggested that earlier cooling may be associated with improved neurological outcomes. We hypothesized that induction of therapeutic hypothermia by paramedics before hospital arrival would improve outcome. Methods and Results— In a prospective, randomized controlled trial, we assigned adults who had been resuscitated from out-of-hospital cardiac arrest with an initial cardiac rhythm of ventricular fibrillation to either prehospital cooling with a rapid infusion of 2 L of ice-cold lactated Ringer’s solution or cooling after hospital admission. The primary outcome measure was functional status at hospital discharge, with a favorable outcome defined as discharge either to home or to a rehabilitation facility. A total of 234 patients were randomly assigned to either paramedic cooling (118 patients) or hospital cooling (116 patients). Patients allocated to paramedic cooling received a median of 1900 mL (first quartile 1000 mL, third quartile 2000 mL) of ice-cold fluid. This resulted in a mean decrease in core temperature of 0.8°C ( P =0.01). In the paramedic-cooled group, 47.5% patients had a favorable outcome at hospital discharge compared with 52.6% in the hospital-cooled group (risk ratio 0.90, 95% confidence interval 0.70 to 1.17, P =0.43). Conclusions— In adults who have been resuscitated from out-of-hospital cardiac arrest with an initial cardiac rhythm of ventricular fibrillation, paramedic cooling with a rapid infusion of large-volume, ice-cold intravenous fluid decreased core temperature at hospital arrival but was not shown to improve outcome at hospital discharge compared with cooling commenced in the hospital. Clinical Trial Registration— URL: http://www.anzctr.org.au. Unique identifier: ACTRN12605000179639.

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Section: Discussionmentioning

confidence: 99%

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

et al. 2010

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“…[59] Several small randomized trials, and nonrandomized observational and retrospective trials, looked at prehospital cooling initiation for patients with OHCA with large-volume ice-cold (4°C) fluids (discussed in more detail in a separate chapter: Prehospital Therapeutic Hypothermia for Cardiac Arrest). [60][61][62][63][64][65][66][67][68] All these studies documented the safety and feasibility if ice-cold fluids for the rapid induction of therapeutic hypothermia. Other promising methods for induction of hypothermia include transnasal cooling device [69] , self-adhesive cooling pads [70] , and cranial cooling caps.…”

Section: Methods For Induction Of Therapeutic Hypothermiamentioning

confidence: 89%

Therapeutic Hypothermia for Cardiac Arrest

Sadaka¹

2013

Therapeutic Hypothermia in Brain Injury

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“…Many clinical and experimental studies focusing on prehospital cardiac arrest have demonstrated that cold fluid resuscitation positively contributes to survival time, hemodynamics, acid-base balance, and neurological and renal functions. [6][7][8][9] Conversely, we observed deleterious effects of this treatment in trauma-related hemorrhagic shock (HS). In the literature, there are only 2 studies that compare fluid resuscitation at different temperatures in HS model, and both of these were pig models.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Warm Fluid and Cold Fluid Resuscitations During Uncontrolled Hemorrhagic Shock Model in Rats

Dilmen

Eryılmaz²,

Balkan³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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Induction of therapeutic hypothermia during prehospital CPR using ice-cold intravenous fluid

Cited by 66 publications

References 31 publications

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

Therapeutic Hypothermia for Cardiac Arrest

Comparison of Warm Fluid and Cold Fluid Resuscitations During Uncontrolled Hemorrhagic Shock Model in Rats

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