[Endovascular or surface cooling?: therapeutic hypothermia after cardiac arrest].
BACKGROUND
Time course, time necessary to achieve the target temperature and stable maintenance, as well as a controlled rewarming period are important factors influencing the outcome of patients after successful cardiopulmonary resuscitation.


METHODS
After successful cardiopulmonary resuscitation a total of 49 patients were cooled via an endovascular or external cooling device to a target temperature of 33 degrees C. Relevant cooling parameters, such as time between admission and initiation of cooling, achievement of target temperature and stable maintenance of cooling therapy, were compared between both groups.


RESULTS
In the endovascular cooling group the target temperature was reached significantly faster (154 +/- 97 min vs. 268 +/- 95 min, p = 0.0002) and showed stable and controlled maintenance of cooling therapy (deviation from target temperature: 0.189 +/- 0.23 degrees C vs 0.596 +/- 0.61 degrees C, p = 0.00006). The rewarming phase was better controlled and length of ICU stay was shorter in the group with endovascular cooling (8.8 +/- 3 vs. 12.9 +/- 6 days).


CONCLUSIONS
Endovascular cooling offers the possibility to reach the target temperature significantly faster and a stable maintenance of therapeutic hypothermia. It is capable of a more controlled rewarming period and shortens the length of ICU stay.
Fink
K
K
Internistische Intensivstationen Heilmeyer, Abteilung für Kardiologie und Angiologie, Albert-Ludwigs-Universität, Freiburg im Breisgau, Germany.
Schwab
T
T
Bode
C
C
Busch
H-J
HJ
D000368:Aged; D001808:Blood Vessels / Q000502:physiology; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D003422:Critical Care; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D017694:Rewarming