A randomized controlled trial comparing the Arctic Sun to standard cooling for induction of hypothermia after cardiac arrest.
BACKGROUND
Hypothermia improves neurological outcome for comatose survivors of out-of-hospital cardiac arrest. Use of computer controlled high surface area devices for cooling may lead to faster cooling rates and potentially improve patient outcome.


OBJECTIVE
To compare the effectiveness of surface cooling with the standard blankets and ice packs to the Arctic Sun, a mechanical device used for temperature management.


METHODS
Multi-center randomized trial of hemodynamically stable comatose survivors of out-of-hospital cardiac arrest.


METHODS
Standard post-resuscitative care inducing hypothermia using cooling blankets and ice (n=30) or the Arctic Sun (n=34).


METHODS
The primary end point was the proportion of subjects who reached a target temperature within 4h of beginning cooling. The secondary end points were time interval to achieve target temperature (34 degrees C) and survival to 3 months.


RESULTS
The proportion of subjects cooled below the 34 degrees C target at 4h was 71% for the Arctic Sun group and 50% for the standard cooling group (p=0.12). The median time to target was 54 min faster for cooled patients in the Arctic Sun group than the standard cooling group (p<0.01). Survival rates with good neurological outcome were similar; 46% of Arctic Sun patients and 38% of standard patients had a cerebral performance category of 1 or 2 at 30 days (p=0.6).


CONCLUSIONS
While the proportion of subjects reaching target temperature within 4h was not significantly different, the Arctic Sun cooled patients to a temperature of 34 degrees C more rapidly than standard cooling blankets.
Heard
Kennon J
KJ
University of Colorado Denver School of Medicine and the Colorado Emergency Medicine Research Center, Denver, CO, United States. kennon.heard@ucdenver.edu
Peberdy
Mary Ann
MA
Sayre
Michael R
MR
Sanders
Arthur
A
Geocadin
Romergryko G
RG
Dixon
Simon R
SR
Larabee
Todd M
TM
Hiller
Katherine
K
Fiorello
Albert
A
Paradis
Norman A
NA
O'Neil
Brian J
BJ
D001831:Body Temperature; D004867:Equipment Design; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome