Induction of therapeutic hypothermia during prehospital CPR using ice-cold intravenous fluid |
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Authors: | Kämäräinen Antti Virkkunen Ilkka Tenhunen Jyrki Yli-Hankala Arvi Silfvast Tom |
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Institution: | Medical School, University of Tampere, Tampere, Finland. antti.kamarainen@uta.fi |
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Abstract: | AIM OF THE STUDY: Primarily, to investigate induction of therapeutic hypothermia during prehospital cardiopulmonary resuscitation (CPR) using ice-cold intravenous fluids. Effects on return of spontaneous circulation (ROSC), rate of rearrest, temperature and haemodynamics were assessed. Additionally, the outcome was followed until discharge from hospital. MATERIALS AND METHODS: Seventeen adult prehospital patients without obvious external causes for cardiac arrest were included. During CPR and after ROSC, paramedics infused +4 degrees C Ringer's acetate aiming at a target temperature of 33 degrees C. RESULTS: ROSC was achieved in 13 patients, 11 of whom were admitted to hospital. Their mean initial nasopharyngeal temperature was 35.17+/-0.57 degrees C (95% CI), and their temperature on hospital admission was 33.83+/-0.77 degrees C (-1.34 degrees C, p<0.001). The mean infused volume of cold fluid was 1571+/-517 ml. The rate of rearrest after ROSC was not increased compared to previous reports. Hypotension was observed in five patients. Of the 17 patients, 1 survived to hospital discharge. CONCLUSION: Induction of therapeutic hypothermia during prehospital CPR and after ROSC using ice-cold Ringer's solution effectively decreased nasopharyngeal temperature. The treatment was easily carried out and well tolerated. |
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