A rapid, safe, and low-cost technique for the induction of mild therapeutic hypothermia in post-cardiac arrest patients

Difference Between Bladder and Esophageal Temperatures in Mild Induced Hypothermia

“…In the induction phase of MIH via cold saline infusion, rapid temperature changes are to be expected (3)(4)(5). A reliable way of measuring temperature changes in an accessible site is needed to prevent overcooling and associated complications, such as dysrhythmias, hypotension, reduced cardiac function, immune suppression, and coagulopathy (4,5).…”

“…Despite widespread use of MIH it remains unclear where to assess body temperature during this procedure (2,3). Measurement of temperature changes is especially important in the induction phase of MIH, where rapid temperature changes occur (4,5).…”

Surface Cooling after Cardiac Arrest: Effectiveness, Skin Safety, and Adverse Events in Routine Clinical Practice

“…Hyperglycemia, hypokalemia, and pneumonia were common adverse events, but the pneumonia rate was well below other reported series [6,30,31], perhaps due to the routine use of prophylactic antibiotics. Although the rate of cooling was slower than other reported series [8,11,16], this reflects a ''real-world'' application, outside of research protocols, and could have been accelerated by the routine use of chilled IV fluids [4,[26][27][28][29], or by initiating cooling with an induction dose of NMB rather than waiting for shivering before giving the first dose-practices the authors have since adopted. Cooling adjuncts (ice packs and cold fluids) were added to expedite the cooling process in only two cases (3%) at physician discretion and for unclear reasons, as both of these patients reached target temperature in less than 4 h.…”

“…Many techniques for inducing and maintaining hypothermia and for performing controlled rewarming have been described, [4][5][6][7][8][9][10][11][12][13][14][15][16] each with a characteristic adverse event (AE) profile. Cooling with ice packs, cold fluids, and cooling mats may result in frequent overcooling.…”

Induction of therapeutic hypothermia via the esophagus:a proof of concept study

“…The cooling rate achieved in this experiment (1.37 °C per hour) compares favorably to other devices, with reported rates ranging from 0.31 °C/h using a saline infusion and application of ice packs to 1.5 °C/h using intravascular catheters, with a multi-modality approach recently reported to achieve a 2.6 °C/h cooling rate. [20,21] …”