• Am J Emerg Med · Apr 2016

    The introduction of an esophageal heat transfer device into a therapeutic hypothermia protocol: A prospective evaluation.

    • Andrej Markota, Jure Fluher, Barbara Kit, Petra Balažič, and Andreja Sinkovič.
    • Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia; Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia. Electronic address: andrejmarkota@hotmail.com.
    • Am J Emerg Med. 2016 Apr 1; 34 (4): 741-5.

    BackgroundTemperature management is a recommended part of post-resuscitation care of comatose survivors of cardiac arrest. A number of methods exist for temperature management, all of which have limitations. We aimed to evaluate the performance and ease of use of a new esophageal heat transfer device (EHTD; Advanced Cooling Therapy, Chicago, IL, USA) for temperature management of adult survivors of cardiac arrest.MethodsWe performed a prospective study from March to June 2015. Our standard protocol uses servo-controlled water blankets supplemented with ice-cold saline in order to attain goal temperature (32°C-34°C) within 1 hour. We substituted the EHTD for our usual water blankets, then recorded temperature over time and adverse effects.Main FindingsA total of 14 patients were treated, with mean age 65.1±13.7 years, and median weight 75.5 (70; 83) kg. Initial temperature was 35.3±1.2°C. Mean cooling rate during the induction phase was 1.12±0.62°C/h, time to target temperature was 60 (41; 195) min and the volume of iced fluids infused was 1607±858 ml (as compared with 2-2.5L historically). The percentage of time outside target temperature range during the maintenance phase was 6.5% (0.0; 29.0). Rewarming rate was 0.22 (0.18; 0.31)°C/h. No major adverse effects were observed.ConclusionUsing the EHTD, our patient population attained goal temperatures in one hour, the volume of ice-cold saline required to attain this cooling rate was decreased by one-third, and experienced a low percentage of time outside target temperature range and no major adverse effects.Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

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