Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19

Temperature management using an intervascular cooling device for a COVID‐19 patient with refractory hyperthermia

“… 4 Additionally, there is a report of a hyperthermic patient with COVID‐19 who was successfully treated using Blanketrol®III, an automated surface cooling device, to maintain normothermia. 5 Intravascular cooling devices, which are mainly used in patients with postcardiac arrest syndrome, may be superior to other external cooling devices in terms of cooling rate and temperature maintenance. 6 Therefore, we performed temperature management using an intravascular cooling device in this COVID‐19 patient with refractory hyperthermia.…”

“…Although there is still no clear evidence of the optimal interventions for infection‐associated hyperthermia, a randomized controlled trial involving external cooling of patients with septic shock showed that external cooling was associated with a significant reduction in 14‐day mortality 4 . Additionally, there is a report of a hyperthermic patient with COVID‐19 who was successfully treated using Blanketrol®III, an automated surface cooling device, to maintain normothermia 5 . Intravascular cooling devices, which are mainly used in patients with postcardiac arrest syndrome, may be superior to other external cooling devices in terms of cooling rate and temperature maintenance 6 .…”

Severe Hypercapnia Requiring 48-h Whole-Body Hypothermia in an Infant with Acute Bronchiolitis

“…During the coronavirus (COVID-19) pandemic, mild therapeutic hypothermia has presented itself as an inexpensive and easily applicable therapy to be used as an alternative to extra corporeal membrane oxygenation, the use of which has been limited due to the discrepancy between the high number of patients who do not respond to ventilatory assistance and the capacity of most health systems. The authors propose that the lowering of body temperature might enhance gas exchange, which is typically increased during the hyperinflammatory state characterizing COVID-19 patients [ 6 ]. Additionally, mild hypothermia reduces cardiac output without altering anaerobic oxygen consumption.…”

“…Based on these beneficial effects, hypothermic treatment has been applied to adult patients with acute respiratory distress syndrome [ 4 , 5 ]. In this regard, a recent case report has described the advantages of treating a patient affected with severe acute respiratory syndrome coronavirus 2, who developed severe acute respiratory distress syndrome resistant to mechanical ventilation, prone position, and muscle relaxants [ 6 ]. Mild hypothermia (temperature between 33.0 °C and 34.0 °C) has brought about rapid improvement in terms of hemodynamics, followed by gain in pulmonary function within 72 h. The possible use of hypothermia has been reported also in infants with others pathological conditions, such as acute respiratory failure and necrotizing colitis [ 4 ] Of importance, 24-h whole-body hypothermia has been performed as a rescue treatment for refractory hypercapnia in a 5-month-old infant with acute bronchiolitis [ 3 ].…”

Design and rationale of the CHILL phase II trial of hypothermia and neuromuscular blockade for acute respiratory distress syndrome

“…Prior reports including a small, non-randomized, clinical trial suggest that TH may mitigate ARDS ( Table 1 ) [ [11] , [12] , [13] , [14] , [15] , [16] , [17] ]. We previously conducted the Cooling to Help Injured Lungs (CHILL) open-label pilot trial to test the feasibility of conducting a RCT of TH and NMB for ARDS [ 18 ].…”