Use of cold intravenous fluid to induce hypothermia in a comatose child after cardiac arrest due to a lightning strike

Kim, Young‐Min; Jeong, Ju-Hwan; Kyong, Yeon-Young; Kim, Han Joon; Kim, Jihoon; Park, Jeong-Ho; Park, Kyu Nam

doi:10.1016/j.resuscitation.2008.07.010

Cited by 7 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only case reports detailing therapeutic hypothermia after lightning strikes exist, and they include 10-and 14-year-old boys resuscitated with surface cooling and a 12-year-old boy treated with chilled fluid and surface cooling. [3][4][5] All had promising neurologic outcomes. Although our resuscitation followed 2012 ACLS protocols, no substantive differences exist for treatment of a PEA arrest as cardiopulmonary resuscitation, and epinephrine remains the cornerstone of treatment.…”

Section: Discussionmentioning

confidence: 99%

Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning Strike

Scantling

Frank

Pontell

et al. 2016

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

Only limited clinical scenarios are grounds for induction of therapeutic hypothermia. Its use in traumatic cardiac arrests, including those from lightning strikes, is not well studied. Nonshockable cardiac arrest rhythms have only recently been included in resuscitation guidelines. We report a case of full neurological recovery with therapeutic hypothermia after a lightning-induced pulseless electrical activity cardiac arrest in an 18-year-old woman. We also review the important pathophysiology of lightning-induced cardiac arrest and neurologic sequelae, elaborate upon the mechanism of therapeutic hypothermia, and add case-based evidence in favor of the use of targeted temperature management in lightning-induced cardiac arrest.

show abstract

Section: Discussionmentioning

confidence: 99%

Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning Strike

Scantling

Frank

Pontell

et al. 2016

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

show abstract

“…Subjects received continuous infusions of analgesics and sedatives and it was not described as to how many were given neuromuscular blocking agents. Additionally, a case report described success using cold saline infusion (30 cc/kg) to induce therapeutic HT in a 12 year old child post–resuscitation from cardiac arrest after the combination of a cooling blanket with sedation and neuromuscular blockade failed 24 . The median time from ICU admission to target temperature in our five patients was relatively long overall due to one child in whom therapeutic HT was initiated later upon decline in mental status.…”

Section: Discussionmentioning

confidence: 99%

Fever control and application of hypothermia using intravenous cold saline

Fink

Kochanek

Clark

et al. 2012

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

Objective To describe the use and feasibility of cold saline to decrease body temperature in pediatric neurocritical care. Design Retrospective chart review. Setting Pediatric tertiary care university hospital. Patients Children between 1 week and 17 yrs of age admitted to the pediatric intensive care unit with acute brain injury and having received intravenous cold saline between June-August 2009. Intervention(s) None. Measurements and Main Results Eighteen subjects accounted for 20 infusions with mean infusion volume 18 ± 10 cc/kg. Eight subjects had traumatic brain injury (TBI), 2 had intracranial hemorrhage, 6 had cardiac arrest, and one each had ischemic stroke and status epilepticus. The mean age was 9.5 ± 4.8 yrs. Temperature decreased from 38.7 ± 1.1°C to 37.7 ± 1.2°C and 37.0 ± 2.0 to 35.3 ± 1.6°C one h after infusion for fever (n=14, p<.05) or hypothermia (HT) induction (n=6, p=.05), respectively. Cold saline was not bolused, rather infused over 10–15 minutes. Mean arterial blood pressure and oxygenation parameters (PaO2/FiO2 ratio, mean airway pressure) were unchanged, but heart rate decreased in HT subjects (121 ± 4 vs. 109 ± 12; p<.05). Serum sodium concentration and International normalized ratio were significantly increased after cold saline infusion. There were no differences between pre- and post-infusion serum glucose and hematocrit, nor cerebral perfusion pressure or intracranial pressure in TBI patients. Conclusions Cold saline was an effective method of reducing temperature in children with acute brain injury. This approach can be considered to treat fever or to induce HT. Prospective study comparing safety and efficacy versus other cooling measures should be considered.

show abstract

“…Larger children and adolescents may require more active therapies to initiate and maintain hypothermia or normothermia. Simple methods such as intravenous iced cold (4°C) saline have been used successfully in adults18–20 and children21 22 and should be easily accessible with minimal resource implications. Alternatively, if available, more complex methods such as servo-controlled surface cooling air or water blankets could be used 23.…”

Section: Discussionmentioning

confidence: 99%

Survey of the use of therapeutic hypothermia after cardiac arrest in UK paediatric emergency departments

et al. 2012

View full text Add to dashboard Cite

Objectives To ascertain current use of therapeutic hypothermia (TH) after paediatric cardiac arrest in UK emergency departments (EDs), and views on participating in a UK randomised controlled trial (RCT) incorporating early induction of TH in ED. Design Anonymous web-based survey of 77 UK Emergency Medicine (EM) consultants from 28 UK EDs that see children during the period AprileJune 2010. Results 62% (48/77) of surveyed consultants responded from 21/28 (75%) EDs. All managed children post cardiac arrest. 90% (43/48) were aware of the literature concerning TH after cardiac arrest in adults. However, 63% (30/48) had never used TH in paediatric practice. All departments had at least one method of inducing TH (surface cooling; air/water blankets; intravenous cold fluid or catheters). Reasons stated for not inducing TH included no equipment available (26%; 11/42), TH not advocated by the local PICU (24%; 10/42) and not enough evidence for its use (24%; 10/42). TH was considered based on advice from the local Paediatric Intensive Care Units (68%; 17/25) or likelihood of recovery after arrest (32%; 8/25). There was strong support for a UK RCT of TH versus normothermia (85%; 40/47). The proposed RCT was felt to be ethical (87%; 40/48) with use of deferred consent acceptable (74%; 34/46). Conclusion UK EM consultants are aware of TH but infrequently initiate the therapy in children for a number of reasons. Their involvement would enable early induction of TH in EDs after paediatric cardiac arrest during a UK RCT. The authors have demonstrated the availability of suitable equipment and EM consultant support for participation in such a RCT.

show abstract

Use of cold intravenous fluid to induce hypothermia in a comatose child after cardiac arrest due to a lightning strike

Cited by 7 publications

References 14 publications

Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning Strike

Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning Strike

Fever control and application of hypothermia using intravenous cold saline

Survey of the use of therapeutic hypothermia after cardiac arrest in UK paediatric emergency departments

Contact Info

Product

Resources

About