Therapeutic hypothermia after cardiac arrest: A retrospective comparison of surface and endovascular cooling techniques

Gillies, Michael; Pratt, Rosalie Rebollo; Whiteley, Craig; Borg, Jamie; Beale, Richard; Tibby, Shane M.

doi:10.1016/j.resuscitation.2010.05.001

Cited by 108 publications

(89 citation statements)

References 21 publications

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“…In a retrospective study by Merchant et al [71] of 32 patients in 3 large centers who underwent surface cooling using a mattress/blanket or ice bag, 63% of patients had temperature less than 32°C for more than 1 h. Temperature fluctuations also occurred throughout both the induction and ADH 0 xxxxx; IV 0 intravenous maintenance phases. This phenomenon has been consistently demonstrated in subsequent studies comparing different cooling methods [72][73][74]. Fans, washing the patient with alcohol baths, and ice immersions should not be used, as they are unpractical in the intensive care unit setting and ineffective for the maintenance and rewarming phases [3].…”

Section: Surface Coolingmentioning

confidence: 80%

Therapeutic Hypothermia for Acute Neurological Injuries

2012

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Therapeutic hypothermia (TH) is the intentional reduction of core body temperature to 32°C to 35°C, and is increasingly applied by intensivists for a variety of acute neurological injuries to achieve neuroprotection and reduction of elevated intracranial pressure. TH improves outcomes in comatose patients after a cardiac arrest with a shockable rhythm, but other off-label applications exist and are likely to increase in the future. This comprehensive review summarizes the physiology and cellular mechanism of action of TH, as well as different means of TH induction and maintenance with potential side effects. Indications of TH are critically reviewed by disease entity, as reported in the most recent literature, and evidence-based recommendations are provided.

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Section: Surface Coolingmentioning

confidence: 80%

Therapeutic Hypothermia for Acute Neurological Injuries

2012

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“…By means of heat exchange with blood catheters achieve hypothermia and maintain it precisely. In spite of these advantages, compared to surface cooling there is no significant difference in outcome [38].…”

Section: Surface Cooling Systemsmentioning

confidence: 99%

“…Venoarterial systems support heart and lung, venovenous systems support lung during ECMO. ECCOR (venovenous, lower blood flow rates system with or without pump) supports only lung 41 [36][37][38][39][40][41][42][43][44][45][46][47][48] ECCOR is provided to remove CO 2 and, unlike ECMO, does not provide significant oxygenation. In contrast to ECMO, where the need for oxygenation requires high blood flow rates, ECCOR allows much lower blood flow rates (500-1000mL/min) and needs smaller access cannulas.…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

“…In conclusion, experience with ECMO has been 43 Karakurt et [36][37][38][39][40][41][42][43][44][45][46][47][48] improving with better survival rates and decreasing morbidity. Considering ECMO for patients with respiratory failure or heart failure when conventional therapies failed, if the underlying pathology is reversible or as a bridge to heart and/or lung transplantation is important.…”

Section: Prognosismentioning

confidence: 99%

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Improvements in intensive care units

Karakurt¹,

Yalçin²,

Arıkan³

2016

MMJ

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We have had some important improvements in the intensive care units (ICU) like high flow oxygen system (HFOS), therapeutic hypothermia, extra corporeal membrane oxygenation (ECMO), extra corporeal carbon dioxide removal (ECCOR), echocardiography (ECHO) and ultrasonography (US).HFOS gives oxygen to the patients at rates of flow higher (up to 60 L/min) than that delivered traditionally in LFOS (up to 16L/ min). It is obtained 1 cmH2O PEEP for every 10L/min of flow delivered by HFOS. HFOS serves as an important alternative to noninvasive mechanical ventilation especially in the management of the patients with hypoxemic respiratory failure.Post-resuscitation care consists of optimization of oxygenation and ventilation, avoiding hypotension, treating immediate precipitants of cardiac arrest such as acute coronary ischemia and initiating therapeutic (induced) hypothermia. Therapeutic hypothermia decreases cerebral metabolic rate, blood volume, and intracranial pressure, prevents reperfusion injury. So hypotermia protects cerebral functions.ECMO, the type of cardiopulmonary support, has become an essential tool in critical care patients with severe respiratory and cardiac failure, refractory to conventional therapy methods.Critical care ultrasonography (CCUS) and echocardiography have utility for intensivist-performed, immediate diagnoses of life threatening diseases, with no need to transport patients to radiology or cardiology departments or wait for radiologist or cardiologist on a consultative basis. CCUS and echocardiography should be an essential part of training of every ICU physician.

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“…[47] Recent studies have demonstrated that endovascular cooling is more accurate in keeping patients in the target temperature range than surface cooling with ice bags and cooling blankets. [79,80] Endovascular cooling also allows for concurrent use of surface warming to reduce shivering. However, endovascular cooling implies accessing the femoral vein to place the cooling catheter, increasing the risk of procedural complications and infection.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Therapeutic Hypothermia in Acute Stroke

Samaniego¹

2013

Therapeutic Hypothermia in Brain Injury

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Therapeutic hypothermia after cardiac arrest: A retrospective comparison of surface and endovascular cooling techniques

Cited by 108 publications

References 21 publications

Therapeutic Hypothermia for Acute Neurological Injuries

Therapeutic Hypothermia for Acute Neurological Injuries

Improvements in intensive care units

Therapeutic Hypothermia in Acute Stroke

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