Effects of large volume, ice-cold intravenous fluid infusion on respiratory function in cardiac arrest survivors

Part 9: Post–Cardiac Arrest Care

“…50 -52 Although a theoretical concern is that rapid fluid loading could have adverse cardiopulmonary effects such as pulmonary edema, 9 case series indicate that cooling can be initiated safely with IV ice-cold fluids (500 mL to 30 mL/kg of saline 0.9% or Ringer's lactate). [51][52][53][54][55][56][57][58][59] One human case series 56 showed that the deterioration in oxygenation that often occurs after ROSC was not significantly affected by the infusion of cold fluids (3427 mL Ϯ 210 mL). Two randomized controlled trials, 60,61 one study with concurrent controls, 62 and 3 case series 63,64 indicate that cooling with IV cold saline can be initiated safely in the prehospital setting.…”

Part 8: Advanced Life Support

“…779 -784 One human study showed that the deterioration in oxygenation that occurs after ROSC was not significantly affected by the infusion of cold 0.9% saline (3427 mL Ϯ210 mL) (LOE 5). 785 Three animal studies reported neurological and cardiac protection with the administration of hypertonic fluid compared to normal saline (LOE 5). 786 -788 One animal study showed an increase in cerebral blood flow with fluid for hemodilution combined with induced hypertension (LOE 5).…”

Local Head and Neck Cooling Leads to Hypothermia in Healthy Volunteers

“…Furthermore, the diagnosis can be misleading in the initial situation and an acceptable benefit-risk ratio must be considered for the cooling method. Up to date, data on the safety of the rapid-saline-infusion method are preliminary [4] and concerns arise from serious fluid overload with respiratory deterioration [5]. In this study, we tested the feasibility, safety and temperature effects of a commercially available cooling cap, covering the surface of the head and neck in healthy volunteers.…”