[Therapeutic hypothermia after cardiac arrest. A cold intravenous fluid, a cooling helmet and a cooling blanket efficiently reduce body temperature].
Two controlled randomized trials have shown that mild systemic hypothermia after cardiac arrest is beneficial for neurological outcome and one of the studies shows an improved survival rate. A pilot study was performed to evaluate a model of induced hypothermia after cardiac arrest, using cold intravenous fluids and surface cooling with a cold helmet and a coldwater blanket (Thermowrap). The main purpose was to evaluate our cooling method regarding efficacy, safety and usability. Five unconscious patients after cardiac arrest were treated with induced hypothermia of whom three survived with good recovery to six-month follow up. Two patients died in the ICU without regaining consciousness. There were no adverse events during treatment. We conclude that our method is reasonably fast compared to other published methods, it is easy to perform and it offers a good temperature control during cooling and rewarming. Routines for evaluating prognosis and neurological outcome after cardiac arrest and hypothermia treatment need to be revised.
Anestesi- och intensivvårdskliniken, Universitetssjukhuset i Lund, Sweden. hans.friberg@skane.se
Hans
H
Friberg
Niklas
N
Nielsen
Torbjörn
T
Karlsson
Tobias
T
Cronberg
Håkan
H
Widner
Elisabet
E
Englund
Anders
A
Ersson
D001512:Bedding and Linens; D001831:Body Temperature; D005500:Follow-Up Studies; D006260:Head Protective Devices; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods; D009460:Neurologic Examination; D010865:Pilot Projects; D011379:Prognosis; D011597:Psychomotor Performance; D012151:Resuscitation / Q000295:instrumentation / Q000379:methods; D017694:Rewarming; D012449:Safety; D014882:Water-Electrolyte Balance