• Ther Hypothermia Temp Manag · Jan 2011

    Can a Cold (4°C) IV Fluid Bolus to Induce Therapeutic Hypothermia Really Deliver 4°C to Children?

    • Alexis Topjian, Michael Hamid, Larissa Hutchins, and Vinay Nadkarni.
    • 1 Department of Anesthesia, Critical Care, and Pediatrics, The Children's Hospital of Philadelphia (CHOP), University of Pennsylvania School of Medicine , Philadelphia, Pennsylvania.
    • Ther Hypothermia Temp Manag. 2011 Jan 1; 1 (2): 95-8.

    AbstractInduced therapeutic hypothermia after pediatric cardiac arrest is under investigation. Animal and adult data suggest that rapid achievement of temperatures (T) <34°C may improve outcomes. Cold intravenous fluids (IVF) rapidly induce hypothermia in adults. We sought to evaluate the actual T of IVF entering a pediatric simulated model when a 4°C 30 mL/kg normal saline bolus was infused at standard rates. At ambient T 25°C, T probes were placed in 4°C 1 L normal saline bags (Tbag) and at distal tip infusion tubing at simulated patient entry (Tin). Simultaneous Tbag and Tin were recorded every 15 seconds during infusion. About 30 mL/kg was infused by pressure bag over 30 minutes for 10 kg (300 mL at 10 mL/min), 25 kg (750 mL at 25 mL/min), and 65 kg (2000 mL at 67 mL/min) patients. Tests were run in duplicate. For 10 kg, Tbag was 6.4°C±1.1°C and Tin was 17°C±0.9°C. For 25 kg, Tbag was 7°C±1.4°C and Tin was 12°C±1.2°C. For 65 kg, Tbag was 5.8°C±1.6°C and Tin was 8.6°C±1.7°C. Tbag

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