title: Prehospital induction of therapeutic hypothermia during CPR: a pilot study.
abstract: OBJECTIVE
  We studied induction of therapeutic hypothermia during prehospital resuscitation from cardiac arrest using an infusion of ice-cold Ringer's solution in five adult patients.
  
  
  METHODS
  Paramedics infused +4 degrees C Ringer's solution into the antecubital vein of the patients with a maximum rate of 33 ml/min to a target temperature of 33.0 degrees C.
  
  
  RESULTS
  The mean infused volume of cold fluid was 14.0 ml/kg, which resulted in a mean decrease of 2.5 degrees C in nasopharyngeal temperature. The decrease in temperature continued after the cessation of infusion in two patients, causing suboptimal temperatures below 32 degrees C.
  
  
  CONCLUSIONS
  We conclude that the infusion of small volumes of ice-cold Ringer's solution during resuscitation results in an effective decrease in nasopharyngeal temperature. Caution should be taken to avoid temperatures below the range of mild therapeutic hypothermia.
authors.affiliation: Medical School, University of Tampere, Tampere, Finland. antti.kamarainen@uta.fi
authors.forename: Antti
authors.initials: A
authors.lastname: Kämäräinen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Virkkunen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Tenhunen
authors.forename: Arvi
authors.initials: A
authors.lastname: Yli-Hankala
authors.forename: Tom
authors.initials: T
authors.lastname: Silfvast
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005240:Feasibility Studies; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000077331:Ringer's Solution
chemical_list: D007552:Isotonic Solutions; D000077331:Ringer's Solution