Inferior Vena Cava Thrombosis Related to Hypothermia Catheter: Report of 20 Consecutive Cases

Reccius, Andrés; Mercado, Pablo; Vargas, Patricio; Canals, Claudio; Montes, Joaquín Morera

doi:10.1007/s12028-014-0069-6

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…In comparison, more invasive methods report higher complication rates, including occult or asymptomatic thrombosis, some of which are considered higher risk due to their more proximal (including caval) location (Simosa et al , 2007; Prunet et al , 2009; Lau et al , 2010; Gierman et al , 2013; Maze et al , 2014; Gillon et al , 2015; Reccius et al , 2015; Wang et al , 2018).…”

Section: Discussionmentioning

confidence: 99%

“…The thrombosis risk from endovascular cooling catheters has been suggested to be higher than standard central line intravascular catheters due to differences in materials (Wang et al , 2018), or shape, where the nonuniform diameter may cause distal eddy flow, blood pooling, and stagnation, in turn, promoting activation of coagulation and the formation of clot in a more proximal location than can be easily visualized with standard compression ultrasonography (Gierman et al , 2013; Gillon et al , 2015; Reccius et al , 2015).…”

Section: Discussionmentioning

confidence: 99%

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Esophageal Temperature Management in Patients Suffering from Traumatic Brain Injury

Bhatti

Naiman

Tsarev

et al. 2019

Therapeutic Hypothermia and Temperature Management

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Traumatic brain injury (TBI) is a leading cause of death in the United States, and represents 2.5 million Emergency Department attendances, admissions into hospital, and deaths. A range of temperature modulating devices have been used to proactively cool TBI patients; however, there are currently no uniform targeted temperature management (TTM) guidelines in this patient population. Esophageal temperature management (ETM) is a relatively new TTM modality and the purpose of this study is to determine whether ETM is effective in controlling core temperature in TBI cases. This prospective interventional trial was a single-site study that enrolled 12 patients who received a TTM protocol using ETM. Eleven out of 12 patients reached target temperature during the first 10 hours of treatment. A total of 480 temperature measurements were recorded; 85% of the total measurements were within-1°C of target temperature (408 measurements) and 75% were within-0.5°C of target temperature (360 measurements). The average time to target was 5.83-5.01 hours (range 1-20), with an average cooling rate of 0.58°C/h (range 0.15-1.5°C/h). This prospective interventional trial supports that ETM is a feasible TTM modality for severe TBI cases. The esophageal heat transfer device used in this study demonstrated comparable or superior performance to other commercially available TTM modalities, and the low adverse event rate may offer advantages over more invasive methods with reported higher complication rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Esophageal Temperature Management in Patients Suffering from Traumatic Brain Injury

Bhatti

Naiman

Tsarev

et al. 2019

Therapeutic Hypothermia and Temperature Management

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show abstract

“…While targeted temperature management promotes good outcomes, the most common temperature modulation techniques introduce risks to patients and logistical challenges to providers (including difficulties in placement, bloodstream infections, blood clots, skin damage, and cost). Esophageal temperature management is designed to overcome these shortcomings 34 35 36 . When appropriately managed, the esophageal temperature management device does not come into contact with the vasculature (as do the intravascular temperature modulation devices) or skin (as do the surface temperature modulation devices), thereby avoiding blood clots, bloodstream infection, and skin degradation.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Naiman

Gray²,

Haymore

et al. 2017

JoVE

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Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time. There are many reported approaches for temperature management, including improvised methods that repurpose standard supplies (e.g., ice, chilled saline, fans, blankets) but more sophisticated technologies designed for temperature management are typically more successful in delivering an optimized protocol. Over the last decade, advanced technologies have developed around two heat transfer methods: surface devices (water blankets, forced-air warmers) or intravascular devices (sterile catheters requiring vascular placement). Recently, a novel device became available that is placed in the esophagus, analogous to a standard orogastric tube, that provides efficient heat transfer through the patient's core. The device connects to existing heat exchange units to allow automatic patient temperature management via a servo mechanism, using patient temperature from standard temperature sensors (rectal, Foley, or other core temperature sensors) as the input variable. This approach eliminates vascular placement complications (deep venous thrombosis, central line associated bloodstream infection), reduces obstruction to patient access, and causes less shivering when compared to surface approaches. Published data have also shown a high degree of accuracy and maintenance of target temperature using the esophageal approach to temperature management. Therefore, the purpose of this method is to provide a low-risk alternative method for controlling patient temperature in critical care settings.

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“…For example, the intravascular cooling methods often outperform surface methods in terms of time to target temperature. [2][3][4][5][6][7][8] However, because intravascular cooling is physician initiated and introduces risks including catheter associated bloodstream infection (CLABSI), deep venous thrombosis (DVT) and pulmonary embolism (PE) [9][10][11][12][13], it may not be an ideal choice for some organizations. Surface devices can be deployed by a wider range of clinicians, such as nurses, and avoid CLABSI and reduce the risks of DVT and PE, but increase the incidence of shivering, which in turn impact temperature maintenance and adds to the overall cost of care.…”

Section: Introductionmentioning

confidence: 99%

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

Wayne

Anderson

Fisher

et al. 2019

Preprint

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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.

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Inferior Vena Cava Thrombosis Related to Hypothermia Catheter: Report of 20 Consecutive Cases

Cited by 12 publications

References 25 publications

Esophageal Temperature Management in Patients Suffering from Traumatic Brain Injury

Esophageal Temperature Management in Patients Suffering from Traumatic Brain Injury

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

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

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