Pilot Randomized Clinical Trial of Prehospital Induction of Mild Hypothermia in Out-of-Hospital Cardiac Arrest Patients With a Rapid Infusion of 4°C Normal Saline

• DOI: 10.1161/circulationaha.106.655480
• Publication Date: 2007-06-05T01:11:25Z
• Authors: Francis Kim; Michele Olsufka; W.T. Longstreth; Charles Maynard; David Carlbom; Steven Deem; Peter Kudenchuk; Michael K. Copass; Leonard A. Cobb
• Keywords: Aged, 80 and over; Male; Emergency Medical Services; Pilot Projects; Middle Aged; Sodium Chloride; Cardiopulmonary Resuscitation; Body Temperature; Heart Arrest; 3. Good health; Cold Temperature; 03 medical and health sciences; Esophagus; Treatment Outcome; 0302 clinical medicine; Hypothermia, Induced; Humans; Female; Infusions, Intravenous; Aged

Although delayed hospital cooling has been demonstrated to improve outcome after cardiac arrest, in-field started immediately the return of spontaneous circulation may be more beneficial. The aims present pilot study were assess feasibility, safety, and effectiveness cooling.We determined effect on esophageal temperature, before arrival, infusing up 2 L 4 degrees C normal saline as soon possible resuscitation from out-of-hospital arrest. A total 125 such patients randomized receive standard care with or without intravenous cooling. Of 63 cooling, 49 (78%) received an infusion 500 2000 mL arrival. These experienced a mean temperature decrease 1.24+/-1 arrival 34.7 C, whereas 62 not increase 0.10+/-0.94 (P<0.0001) 35.7 C. In-field was associated adverse consequences in terms blood pressure, heart rate, arterial oxygenation, evidence for pulmonary edema initial chest x-ray, rearrest. Secondary end points awakening discharged alive trended toward improvement ventricular fibrillation cooling.These data suggest that field is feasible, safe, effective lowering temperature. We propose this method neurological arrest studied larger numbers patients, especially those whose rhythm fibrillation.