A rapid, safe, and low-cost technique for the induction of mild therapeutic hypothermia in post-cardiac arrest patients

被引：27

作者：

Kory, Pierre ^{[1
]}

Weiner, Justin ^{[2
]}

Mathew, Joseph P. ^{[1
]}

Fukunaga, Mayuko ^{[1
]}

Palmero, Veronica ^{[1
]}

Singh, Bimaljeet ^{[1
]}

Haimowitz, Stephanie ^{[3
]}

Clark, Elana T. ^{[3
]}

Fischer, Alyssa ^{[3
]}

Mayo, Paul H. ^{[4
]}

机构：

[1] Beth Israel Deaconess Med Ctr, Div Pulm Crit Care & Sleep Med, New York, NY 10003 USA

[2] Beth Israel Deaconess Med Ctr, Internal Med Residency Program, New York, NY 10003 USA

[3] Albert Einstein Coll Med, New York, NY USA

[4] N Shore Long Isl Jewish Med Ctr, Div Pulm Crit Care & Sleep Med, New Hyde Pk, NY 11040 USA

来源：

RESUSCITATION | 2011年 / 82卷 / 01期

关键词：

Hypothermia; Advanced life support (ALS); Witnessed cardiac arrest; Post-resuscitation period; Cardiac arrest; INTENSIVE-CARE UNITS; COLD INTRAVENOUS FLUID; COMATOSE SURVIVORS; RESUSCITATIVE HYPOTHERMIA; CLINICAL-PRACTICE; HEAT-STROKE; IMPLEMENTATION; FEASIBILITY; EFFICACY; IMPROVE;

D O I：

10.1016/j.resuscitation.2010.08.020

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Aim of study: The benefits of inducing mild therapeutic hypothermia (MTH) in cardiac arrest patients are well established. Timing and speed of induction have been related to improved outcomes in several animal trials and one human study. We report the results of an easily implemented, rapid, safe, and low-cost protocol for the induction of MTH. Methods: All in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) patients admitted to an intensive care unit meeting inclusion criteria were cooled using a combination modality of rapid, cold saline infusion (CSI), evaporative surface cooling, and ice water gastric lavage. Cooling tasks were performed with a primary emphasis on speed. The main endpoints were the time intervals between return of spontaneous circulation (ROSC), initiation of hypothermia (IH), and achievement of target temperature (TT). Results: 65 patients underwent MTH during a 3-year period. All patients reached target temperature. Median ROSC-TT was 134 min. Median ROSC-IH was 68 min. Median IH-TT was 60 min. IH-TT cooling rate was 2.6 degrees C/h. Complications were similar to that of other large trials. 31% of this mixed population of IHCA and OHCA patients recovered to a Pittsburgh cerebral performance score (CPC) of 1 or 2. Conclusion: A protocol using a combination of core and surface cooling modalities was rapid, safe, and low cost in achieving MTH. The cooling rate of 2.6 degrees C/h was superior to most published protocols. This method uses readily available equipment and reduces the need for costly commercial devices. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：15 / 20

页数：6

共 50 条

[31] Accuracy of continuous thermodilution cardiac output monitoring by pulmonary artery catheter during therapeutic hypothermia in post-cardiac arrest patients [J].

Ameloot, K. ;

Meex, I. ;

Genbrugge, C. ;

Jans, F. ;

Malbrain, M. ;

Mullens, W. ;

Dens, J. ;

De Deyne, C. ;

Dupont, M. .

RESUSCITATION, 2014, 85 (09) :1263-1268

[32] Minimal effects on ex vivo coagulation during mild therapeutic hypothermia in post cardiac arrest patients [J].

Brinkman, A. C. M. ;

ten Tusscher, B. L. ;

de Waard, M. C. ;

de Man, F. R. ;

Girbes, A. R. J. ;

Beishuizen, A. .

RESUSCITATION, 2014, 85 (10) :1359-1363

[33] The frequency and timing of epileptiform activity on continuous electroencephalogram in comatose post-cardiac arrest syndrome patients treated with therapeutic hypothermia [J].

Mani, Ram ;

Schmitt, Sarah E. ;

Mazer, Maryann ;

Putt, Mary E. ;

Gaieski, David F. .

RESUSCITATION, 2012, 83 (07) :840-847

[34] Effectiveness of Induced Hypothermia on the Prognosis of Post-cardiac Arrest Patients: A Scoping Literature Review [J].

Rohit, Ralph Kingsford ;

Tibrewal, Charu ;

Modi, Naisargi Shrikant ;

Bajoria, Parth S. ;

Dave, Prathma Anandbhai ;

Gandhi, Siddharth Kamal ;

Patel, Priyansh .

CUREUS JOURNAL OF MEDICAL SCIENCE, 2023, 15 (08)

[35] Importance of Both Early Reperfusion and Therapeutic Hypothermia in Limiting Myocardial Infarct Size Post-Cardiac Arrest in a Porcine Model [J].

Kern, Karl B. ;

Hanna, Joseph M. ;

Young, Hayley N. ;

Ellingson, Carl J. ;

White, Joshua J. ;

Heller, Brian ;

Illindala, Uday ;

Hsu, Chiu-Hsieh ;

Zuercher, Mathias .

JACC-CARDIOVASCULAR INTERVENTIONS, 2016, 9 (23) :2403-2403

[36] Impact of Fever on Neurologic Outcome in Patients Undergoing Therapeutic Hypothermia Post Cardiac Arrest [J].

Thanawala, Prachi U. ;

Fonseka, Natasha ;

Marhefka, Gregary .

CIRCULATION, 2014, 130

[37] Relation Between Sedative and Outcomes in Patients Undergoing Mild Therapeutic Hypothermia Following Cardiac Arrest [J].

Baker, William I. ;

Geronila, Giovanni ;

Kallur, Ramya ;

Noyes, Adam ;

Lundbye, Justin B. .

CIRCULATION, 2012, 126 (21)

[38] Cold infusions alone are effective for induction of therapeutic hypothermia but do not keep patients cool after cardiac arrest [J].

Kliegel, Andreas ;

Janata, Andreas ;

Wandaller, Cosima ;

Uray, Thomas ;

Spiel, Alexander ;

Losert, Heidrun ;

Kliegel, Matthias ;

Holzer, Michael ;

Haugk, Moritz ;

Sterz, Fritz ;

Laggner, Anton N. .

RESUSCITATION, 2007, 73 (01) :46-53

[39] A knowledge translation collaborative to improve the use of therapeutic hypothermia in post-cardiac arrest patients: protocol for a stepped wedge randomized trial [J].

Katie N Dainty ;

Damon C Scales ;

Steve C Brooks ;

Dale M Needham ;

Paul Dorian ;

Niall Ferguson ;

Gordon Rubenfeld ;

Randy Wax ;

Merrick Zwarenstein ;

Kevin Thorpe ;

Laurie J Morrison .

Implementation Science, 6

[40] Serum procalcitonin as a marker of post-cardiac arrest syndrome and long-term neurological recovery, but not of early-onset infections, in comatose post-anoxic patients treated with therapeutic hypothermia [J].

Engel, Harald ;

Ben Hamouda, Nawfel ;

Portmann, Katharina ;

Delodder, Frederik ;

Suys, Tamarah ;

Feihl, Francois ;

Eggimann, Philippe ;

Rossetti, Andrea O. ;

Oddo, Mauro .

RESUSCITATION, 2013, 84 (06) :776-781

← 1 2 3 4 5 →