The use of pre-hospital mild hypothermia after resuscitation from out-of-hospital cardiac arrest.
Hypothermia has emerged as a potent neuroprotective modality following resuscitation from cardiac arrest. Although delayed hospital cooling has been demonstrated to improve outcome after cardiac arrest, in-field cooling begun immediately following the return of spontaneous circulation may be more beneficial. Cooling in the field following resuscitation, however, presents new challenges, in that the cooling method has to be portable, safe, and effective. Rapid infusion of intravenous fluid at 4 degrees C, the use of a cooling helmet, and cooling plates have all been proposed as methods for field cooling, and are all in various stages of clinical and animal testing. Whether field cooling will improve survival and neurologic outcome remains an important unanswered clinical question.
Kim
Francis
F
Department of Medicine and Neurology, University of Washington, Seattle, Washington 98104, USA. fkim@u.washington.edu
Olsufka
Michele
M
Nichol
Graham
G
Copass
Michael K
MK
Cobb
Leonard A
LA
D001831:Body Temperature / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000503:physiopathology; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000592:standards / Q000639:trends; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards / Q000639:trends; D006260:Head Protective Devices / Q000592:standards / Q000639:trends; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D007262:Infusions, Intravenous / Q000379:methods; D012151:Resuscitation / Q000379:methods* / Q000592:standards / Q000639:trends