Therapeutic hypothermia induced during cardiopulmonary resuscitation using large-volume, ice-cold intravenous fluid.
BACKGROUND
Therapeutic hypothermia after resuscitation improves outcome following prolonged out-of-hospital cardiac arrest. Laboratory studies suggest that this therapy may improve outcome further when induced during cardiopulmonary resuscitation. We report a case where therapeutic hypothermia was induced during cardiopulmonary resuscitation using large-volume (40 mL/kg), ice-cold (4 degrees C) intravenous fluid.


METHODS
Case report.


METHODS
A tertiary level hospital in Victoria, Australia.


METHODS
The patient suffered a cardiac arrest secondary to pericardial tamponade following right ventricular perforation during cardiac catheterisation. Percutaneous needle drainage was unsuccessful and open drainage via a left emergency thoracotomy was performed. Therapeutic hypothermia during cardiopulmonary resuscitation was induced using of a rapid infusion of large-volume (40 mL/kg), ice-cold (4 degrees C) crystalloid fluid. A spontaneous circulation was restored after 37 min of cardiac arrest. The patient made a satisfactory neurological recovery.


CONCLUSIONS
Treatment with a rapid intravenous infusion of large-volume (40 mL/kg), ice-cold (4 degrees C) fluid during cardiopulmonary resuscitation induces mild hypothermia and may provide neurological protection. Further clinical studies of this approach are warranted.
Bernard
Stephen A
SA
The Intensive Care Unit, Knox Private Hospital, 262 Mountain Highway, Wantirna South, Victoria 3154, Australia. stephen.bernard@healthscope.com.au
Rosalion
Alexander
A
D001831:Body Temperature; D002305:Cardiac Tamponade / Q000628:therapy; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008875:Middle Aged; D013696:Temperature
D007552:Isotonic Solutions