A prospective, multicenter pilot study to evaluate the feasibility and safety of using the CoolGard™ System and Icy™ catheter following cardiac arrest

Al-Senani, Fahmi; Graffagnino, Carmelo; Grotta, James C.; Saiki, Robin; Wood, Denise; Chung, William; Palmer, Grant; Collins, Ken A

doi:10.1016/j.resuscitation.2004.02.016

Cited by 195 publications

(69 citation statements)

References 30 publications

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“…Using the same background, the International Liaison Committee on Resuscitation (ILCOR) issued an advisory statement (4) strongly encouraging the use of TH, also in patients with non-VF as initial rhythm. Different cooling methods and devices are available (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Still, TH has not been accepted as standard therapy (16)(17)(18)(19).…”

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confidence: 99%

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Busch

Søreide

Lossius

et al. 2006

Acta Anaesthesiol Scand

149

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Background: The implementation of therapeutic hypothermia (TH) into daily clinical practice appears to be slow. We present our experiences with rapid implementation of a simple protocol for TH in comatose out-of-hospital cardiac arrest (OHCA) survivors. Methods: From June 2002, we started cooling pre-hospitally with sport ice packs in the groin and over the neck. In the intensive care unit (ICU), we used ice-water soaked towels over the torso. All patients were endotracheally intubated, on mechanical ventilation and sedated and paralysed. The target temperature was 33 AE 1 8C to be maintained for 12-24 h. We used simple inclusion criteria: (i) no response to verbal command during the ambulance transport independent of initial rhythm and cause of CA; (ii) age 18-80 years; and (iii) absence of cardiogenic shock (SBP < 90 mmHg despite vasopressors). We compared the first 27 comatose survivors with a presumed cardiac origin of their OHCA with 34 historic controls treated just before implementation. Results: TH was initiated in all 27 eligible patients. The target temperature was reached in 24 patients (89% success rate). ICUand hospital-length of stay did not differ significantly before and after implementation of TH. Hypokalemia (P ¼ 0.001) and insulin

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confidence: 99%

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Busch

Søreide

Lossius

et al. 2006

Acta Anaesthesiol Scand

149

View full text Add to dashboard Cite

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“…Several methods have been proposed to induce rapid hypothermia, including the use of cooling blankets, placement of intravascular heat exchange catheters, and cooling helmets. [13][14][15] Each has limitations, especially for use outside the hospital setting.…”

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confidence: 99%

Pilot Study of Rapid Infusion of 2 L of 4°C Normal Saline for Induction of Mild Hypothermia in Hospitalized, Comatose Survivors of Out-of-Hospital Cardiac Arrest

et al. 2005

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Background-Recent clinical studies have demonstrated that mild hypothermia (32°C to 34°C) induced by surface cooling improves neurological outcome after resuscitation from out-of-hospital cardiac arrest. Results from animal models suggest that the effectiveness of mild hypothermia could be improved if initiated as soon as possible after return of spontaneous circulation. Infusion of cold, intravenous fluid has been proposed as a safe, effective, and inexpensive technique to induce mild hypothermia after cardiac arrest. Methods and Results-In 17 hospitalized survivors of out-of-hospital cardiac arrest, we determined the effect on temperature and hemodynamics of infusing 2 L of 4°C cold, normal saline during 20 to 30 minutes into a peripheral vein with a high-pressure bag. Data on vital signs, electrolytes, arterial blood gases, and coagulation were collected before and after fluid infusion.

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“…In contrast to other cooling devices with automatic temperature feedback control, 6,22,28 the use of the cooling pad requires temperature management. In a recent study, cooling with ice packs and conventional cooling blankets resulted in unintentional overcooling in the majority of patients.…”

Section: Discussionmentioning

confidence: 99%

Surface Cooling for Rapid Induction of Mild Hypothermia After Cardiac Arrest: Design Determines Efficacy

Uray

Haugk

Sterz

et al. 2010

Academic Emergency Medicine

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Objectives: Recently, a novel cooling pad was developed for rapid induction of mild hypothermia after cardiac arrest. The aim of this study was to evaluate the cooling efficacy of three different pad designs for in-hospital cooling.Methods: Included in this prospective interventional study were patients with esophageal temperature (Tes) > 34°C on admission. The cooling pad consists of multiple cooling units, filled with a combination of graphite and water, which is precooled to -18°C (design A) or to -9°C (designs B and C) before use. The designs of the cooling pad differed in number, shape, and thickness of the cooling units, with weights of 9.7 kg (design A), 5.3 kg (design B), and 6.2 kg (design C). All three designs were tested in sequential order and were changed according to the results found in the previous trial. Cooling was started after admission until Tes = 34°C, when the cooling pad was removed. The target temperature of Tes = 32-34°C was maintained for 24 hours. Data are presented as medians and interquartile ranges (IQRs = 25%-75%) or proportions.Results: Cooling rates were 3.4°C ⁄ hour (IQR = 2.5-3.7) with design A (n = 12), 2.8°C ⁄ hour (IQR = 1.6-3.3) with design B (n = 7), and 2.9°C ⁄ hour (IQR = 1.9-3.6) with design C (n = 10; p = 0.5). To reach 34°C, the cooling pad had to be exchanged with a new one due to melting and therefore depleting cooling capacity in three patients with design A, in five patients with design B, and in no patient with design C (p = 0.004). Conclusions:With adequate design and storage temperature, the cooling pad proved to be efficient for rapid in-hospital cooling of patients resuscitated from cardiac arrest.

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A prospective, multicenter pilot study to evaluate the feasibility and safety of using the CoolGard™ System and Icy™ catheter following cardiac arrest

Cited by 195 publications

References 30 publications

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Pilot Study of Rapid Infusion of 2 L of 4°C Normal Saline for Induction of Mild Hypothermia in Hospitalized, Comatose Survivors of Out-of-Hospital Cardiac Arrest

Surface Cooling for Rapid Induction of Mild Hypothermia After Cardiac Arrest: Design Determines Efficacy

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