Prehospital induction of mild hypothermia with cold normal saline for cardiac arrest: more harm than good?

Yajnik, Vishal; Gómez, Hernando

doi:10.1186/s13054-014-0559-0

Cited by 3 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our previous study demonstrated that intravenous infusion of cold saline (ICS) was not the correct choice as an intra-arrest cooling method [ 8 ]. ICS is not an ideal method to maintain target temperature and an excessive volume load may compromise the resuscitation outcomes [ 9 , 10 ]. However, ICS is an attractive strategy to achieve early cooling after resuscitation when compared with surface cooling.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Short Duration Combined Mild Hypothermia Improves Resuscitation Outcomes in a Porcine Model of Prolonged Cardiac Arrest

Yang

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Objective. In this study, our aim was to investigate the effects of combined hypothermia with short duration maintenance on the resuscitation outcomes in a porcine model of ventricular fibrillation (VF). Methods. Fourteen porcine models were electrically induced with VF and untreated for 11 mins. All animals were successfully resuscitated manually and then randomized into two groups: combined mild hypothermia (CH group) and normothermia group (NT group). A combined hypothermia of ice cold saline infusion and surface cooling was implemented in the animals of the CH group and maintained for 4 hours. The survival outcomes and neurological function were evaluated every 24 hours until a maximum of 96 hours. Neuron apoptosis in hippocampus was analyzed. Results. There were no significant differences in baseline physiologies and primary resuscitation outcomes between both groups. Obvious improvements of cardiac output were observed in the CH group at 120, 180, and 240 mins following resuscitation. The animals demonstrated better survival at 96 hours in the CH group when compared to the NT group. In comparison with the NT group, favorable neurological functions were observed in the CH group. Conclusion. Short duration combined cooling initiated after resuscitation improves survival and neurological outcomes in a porcine model of prolonged VF.

show abstract

Section: Introductionmentioning

confidence: 99%

“…However, ICS is an attractive strategy to achieve early cooling after resuscitation when compared with surface cooling. ICS is easy to administrate and has a shorter induction period [ 3 , 9 , 11 ]. Therefore, in-time limited volume ICS combined with surface cooling might be a better cooling strategy following resuscitation.…”

Section: Introductionmentioning

confidence: 99%

Short Duration Combined Mild Hypothermia Improves Resuscitation Outcomes in a Porcine Model of Prolonged Cardiac Arrest

Yang

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

show abstract

Prehospital therapeutic hypothermia after out-of-hospital cardiac arrest: a systematic review and meta-analysis

Nie

Dong

Zhang

et al. 2016

The American Journal of Emergency Medicine

View full text Add to dashboard Cite

Temperature control in critically ill patients with a novel esophageal cooling device: a case series

et al. 2015

View full text Add to dashboard Cite

BackgroundMild hypothermia and fever control have been shown to improve neurological outcomes post cardiac arrest. Common methods to induce hypothermia include body surface cooling and intravascular cooling; however, a new approach using an esophageal cooling catheter has recently become available.MethodsWe report the first three cases of temperature control using an esophageal cooling device (ECD). The ECD was placed in a similar fashion to orogastric tubes. Temperature reduction was achieved by connecting the ECD to a commercially available external heat exchange unit (Blanketrol Hyperthermia – Hypothermia System).ResultsThe first patient, a 54 year-old woman (86 kg) was admitted after resuscitation from an out-of-hospital non-shockable cardiac arrest. Shortly after admission, she mounted a fever peaking at 38.3 °C despite administration of cold intravenous saline and application of cooling blankets. ECD utilization resulted in a temperature reduction to 35.7 °C over a period of 4 h. She subsequently recovered and was discharged home at day 23. The second patient, a 59 year-old man (73 kg), was admitted after successful resuscitation from a protracted out-of hospital cardiac arrest. His initial temperature was 35 °C, but slowly increased to 35.8 °C despite applying a cooling blanket and ice packs. The ECD was inserted and a temperature reduction to 34.8 °C was achieved within 3 h. The patient expired on day 3. The third patient, a 47 year-old man (95 kg) presented with a refractory fever secondary to necrotizing pneumonia in the postoperative period after coronary artery bypass grafting. His fever persisted despite empiric antibiotics, antipyretics, cooling blankets, and ice packs. ECD insertion resulted in a decrease in temperature from 39.5 to 36.5 °C in less than 5 h. He eventually made a favorable recovery and was discharged home after 59 days. In all 3 patients, device placement occurred in under 3 min and ease-of-use was reported as excellent by nursing staff and physicians.ConclusionsThe esophageal cooling device was found to be an effective temperature control modality in this small case series of critically ill patients. Preliminary data presented in this report needs to be confirmed in large randomized controlled trials comparing its efficacy and safety to standard temperature control modalities.

show abstract

Prehospital induction of mild hypothermia with cold normal saline for cardiac arrest: more harm than good?

Abstract: No abstract.

Cited by 3 publications

References 11 publications

Short Duration Combined Mild Hypothermia Improves Resuscitation Outcomes in a Porcine Model of Prolonged Cardiac Arrest

Short Duration Combined Mild Hypothermia Improves Resuscitation Outcomes in a Porcine Model of Prolonged Cardiac Arrest

Prehospital therapeutic hypothermia after out-of-hospital cardiac arrest: a systematic review and meta-analysis

Temperature control in critically ill patients with a novel esophageal cooling device: a case series

Contact Info

Product

Resources

About