Prehospital induction of therapeutic hypothermia during CPR: a pilot study.
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.
Kämäräinen
Antti
A
Medical School, University of Tampere, Tampere, Finland. antti.kamarainen@uta.fi
Virkkunen
Ilkka
I
Tenhunen
Jyrki
J
Yli-Hankala
Arvi
A
Silfvast
Tom
T
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
D007552:Isotonic Solutions; D000077331:Ringer's Solution