Efficacy of and tolerance to mild induced hypothermia after out-of-hospital cardiac arrest using an endovascular cooling system

Abstract

Introduction We evaluated the efficacy of and tolerance to mild therapeutic hypothermia achieved using an endovascular cooling system, and its ability to reach and maintain a target temperature of 33°C after cardiac arrest.

Trombosis venosa mayor asociada a catéter de hipotermia terapéutica en un paciente con paro cardiorrespiratorio recuperado: comunicación de un caso y revisión de la literatura

“…Al revisar las grandes casuísticas de pacientes sometidos a este tratamiento, no se establece la aparición de trombosis venosa como outcome importante a evaluar, sin embargo, existen comunicaciones de casos aislados con esta complicación. Pichon y cols, revisan una serie de 34 pacientes sometidos a HT de 33°C por un período promedio de 37 horas, realizando Doppler sistemáticamente a todos los pacientes una vez retirado el catéter, no encontraron casos de trombosis, posterior al retiro del catéter, por criterio clínico ni ultrasonográfi co 12 . Taylor y cols, publicaron su experiencia con 11 pacientes que usaron catéter Icy, describiendo sólo un caso de tromboembolismo pulmonar y trombosis venosa asociada al catéter, no se describe en este caso el tiempo de uso del catéter 9 .…”

Hypothermia in Stroke Therapy: Systemic versus Local Application

“…The approach was shown in both cases to reduce body temperature more rapidly than surface cooling could accomplish, and since a temperature probe is embedded in the catheter, precise temperature monitoring and regulation was far superior to surface-cooling methods. The disadvantages of systemic endovascular hypothermia induction stem from its invasive nature; the method carries a much higher risk of deep venous thrombosis (DVT), bacteremia, and sepsis than surface cooling [16,17]. Additionally, the Intravascular Cooling in the Treatment of Stroke-Longer tPA Window (ICTuS-L) study results showed a statistically signiicant increase in the occurrence of pneumonias in patients receiving systemic endovascular TH [18].…”

Therapeutic Hypothermia for Acute Neurological Injuries

“…The Alsius (Alsius Corp.) catheter has 3 cylindrical balloons filled with saline in a closed system near the tip of the catheter with a feedback system to the bedside unit. Using a core temperature monitor, the patient's temperature is regulated via an automatic adjustment of the saline temperature in the cylindrical balloons [82]. The Celsius (Innercool Therapies) catheter has a flexible distal metallic heat transfer unit, which contains cold saline and a patient body temperature sensing probe.…”

“…In a study of TBI patients, the incidence of asymptomatic DVT was as great as 50% when using endovascular cooling devices [86]. A sixfold increase of the nosocomial bloodstream infection rate (13% vs a control rate of 2%) was found in another study of endovascular cooling catheters [82]. Therefore, endovascular cooling is currently only used in patients in whom cooling is expected to last no longer than 24 h, with prompt removal of the catheter after this time period to prevent DVT and bacteremia.…”