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Neurocritical Care

, Volume 7, Issue 2, pp 109–118 | Cite as

Therapeutic Hypothermia after Cardiac Arrest: Performance Characteristics and Safety of Surface Cooling with or without Endovascular Cooling

  • Alexander C. FlintEmail author
  • J. Claude Hemphill
  • David C. Bonovich
Original Paper

Abstract

Introduction

Various methods are available to induce and maintain therapeutic hypothermia after cardiac arrest, but little data is available comparing device-mediated cooling to simple surface methods in this setting.

Methods

To assess the performance characteristics of simple surface cooling with or without an endovascular cooling catheter system, we retrospectively reviewed all cases of hypothermia for comatose survivors of cardiac arrest treated at a single academically affiliated urban hospital. Forty two comatose survivors of cardiac arrest were treated over a 3.5-year period. Hypothermia was induced and maintained by simple surface methods (ice packs, cooling blankets) with or without placement of an endovascular cooling catheter system with automated temperature feedback regulation.

Results

Overall, the rate of active cooling was not different between patients treated with endovascular catheter-assisted hypothermia and patients treated with surface cooling alone. However, use of a larger (14 F) catheter was associated with faster cooling rates. Maintenance of goal temperature (33°C) was far better controlled with the use of a cooling catheter. Use of surface cooling alone was associated with significant temperature overshoot. Patients treated with surface cooling alone spent more time bradycardic.

Conclusion

Use of an endovascular cooling catheter as part of a treatment protocol for hypothermia after cardiac arrest provides better control during maintenance of hypothermia, preventing temperature overshoot. Active cooling rates may be enhanced by the use of a larger cooling catheter.

Keywords

Cardiac arrest Cardiopulmonary resuscitation Anoxic brain injury Therapeutic hypothermia 

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Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Alexander C. Flint
    • 1
    Email author
  • J. Claude Hemphill
    • 1
    • 2
  • David C. Bonovich
    • 1
    • 2
  1. 1.Neurovascular and Neurocritical Care ServiceUniversity of California San FranciscoSan FranciscoUSA
  2. 2.San Francisco General HospitalNeurocritical Care ServiceSan FranciscoUSA

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