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Comparative evaluation of the usability of 2 different methods to perform mild hypothermia in patients with out-of-hospital cardiac arrest.

Abstract：

BACKGROUND:Several studies have shown that mild hypothermia (32-34°C) markedly mitigates brain damage after cardiac arrest (CA). This study aimed to compare the efficacy of the non-invasive cooling device Hilotherm Clinic (Hilotherm GmbH, Germany) with conventional cooling to induce and maintain mild hypothermia in patients after out-of-hospital CA. METHODS:50 adult patients with an indication for controlled mild hypothermia were prospectively assigned to conventional cooling (n=20) or cooling with the Hilotherm system (n=30). Patients receiving a cooling therapy by Hilotherm were treated either with 0.35 m(2) (n=20) or with 0.7 m(2) (n=10) surface area of cooling sleeves. RESULTS:The speed of cooling was significantly higher in both Hilotherm groups compared to conventional cooling (Hilotherm 0.7 m(2): 0.91 ± 0.08°C/h, Hilotherm 0.35 m(2): 0.47 ± 0.04°C/h, and conventional: 0.3 ± 0.04°C/h, p ≤ 0.003). Temperature deviation from the target temperature of 33°C was significantly higher in the conventional group compared to both Hilotherm groups. During induction of mild hypothermia a significant reduction of the mean arterial blood pressure and the heart rate was observed without significant differences between the groups. However, the speed of cooling (range 0.3-0.91°C/h) did not correlate to the decrease of blood pressure and heart rate. Norepinephrine dosing during induction of mild hypothermia and re-warming (1st-2nd day) was significantly increased compared to the 3rd day after admission in all groups. Dobutamine dosing and 30 days in-hospital mortality did not differ significantly between the groups. CONCLUSIONS:Rapid and reliable mild hypothermia can be better achieved by the non-invasive cooling system Hilotherm compared to conventional cooling with ice packs and cold infusion.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Rana M,W Schröder J,Saygili E,Hameed U,Benke D,Hoffmann R,Schauerte P,Marx N,Rana OR

doi

10.1016/j.ijcard.2010.07.026

subject

Has Abstract

pub_date

2011-11-03 00:00:00

pages

321-6

issue

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(10)00553-X

journal_volume

152

pub_type

杂志文章

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Comparative evaluation of the usability of 2 different methods to perform mild hypothermia in patients with out-of-hospital cardiac arrest.