title: The introduction of an esophageal heat transfer device into a therapeutic hypothermia protocol: A prospective evaluation.
abstract: BACKGROUND
  Temperature management is a recommended part of post-resuscitation care of comatose survivors of cardiac arrest. A number of methods exist for temperature management, all of which have limitations. We aimed to evaluate the performance and ease of use of a new esophageal heat transfer device (EHTD; Advanced Cooling Therapy, Chicago, IL, USA) for temperature management of adult survivors of cardiac arrest.
  
  
  METHODS
  We performed a prospective study from March to June 2015. Our standard protocol uses servo-controlled water blankets supplemented with ice-cold saline in order to attain goal temperature (32°C-34°C) within 1 hour. We substituted the EHTD for our usual water blankets, then recorded temperature over time and adverse effects.
  
  
  RESULTS
  A total of 14 patients were treated, with mean age 65.1±13.7 years, and median weight 75.5 (70; 83) kg. Initial temperature was 35.3±1.2°C. Mean cooling rate during the induction phase was 1.12±0.62°C/h, time to target temperature was 60 (41; 195) min and the volume of iced fluids infused was 1607±858 ml (as compared with 2-2.5L historically). The percentage of time outside target temperature range during the maintenance phase was 6.5% (0.0; 29.0). Rewarming rate was 0.22 (0.18; 0.31)°C/h. No major adverse effects were observed.
  
  
  CONCLUSIONS
  Using the EHTD, our patient population attained goal temperatures in one hour, the volume of ice-cold saline required to attain this cooling rate was decreased by one-third, and experienced a low percentage of time outside target temperature range and no major adverse effects.
authors.affiliation: Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia; Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia. Electronic address: andrejmarkota@hotmail.com.
authors.forename: Andrej
authors.initials: A
authors.lastname: Markota
authors.affiliation: Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
authors.forename: Jure
authors.initials: J
authors.lastname: Fluher
authors.affiliation: Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kit
authors.affiliation: Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
authors.forename: Petra
authors.initials: P
authors.lastname: Balažič
authors.affiliation: Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia; Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia.
authors.forename: Andreja
authors.initials: A
authors.lastname: Sinkovič
mesh_terms: D000368:Aged; D001833:Body Temperature Regulation; D003128:Coma / Q000209:etiology; D004947:Esophagus; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D011446:Prospective Studies