Therapeutic hypothermia and temperature management
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Ther Hypothermia Temp Manag · Mar 2018
Case ReportsRewarming After Severe Accidental Hypothermia Using the Esophageal Heat Transfer Device: A Case Report.
Patients with severe accidental hypothermia require active rewarming. External rewarming may not be successful in severe hypothermia, and use of invasive techniques is limited to regional centers and is associated with vascular access site and other complications. We present a patient with severe accidental hypothermia who was successfuly rewarmed using a novel esophageal heat transfer device. ⋯ After rewarming, we maintained his body temperature in the range 35-36°C until accidental removal of the device. We observed no major adverse effects. To conclude, rewarming from severe accidental hypothermia was possible using the esophageal heat transfer device.
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Ther Hypothermia Temp Manag · Mar 2018
Feasibility Study of a Novel High-Flow Cold Air Cooling Protocol of the Porcine Brain Using MRI Temperature Mapping.
Early, prehospital cooling seeks to reduce and control the body temperature as early as possible to protect the brain and improve patient outcome in cardiac arrest, stroke, and traumatic brain injury. In this study, we investigate the feasibility of localized cooling of the porcine brain by using a novel high-flow cold air protocol, which utilizes the close proximity between the nasal cavity and the brain. Five adult pigs were anesthetized and temperature change was mapped before, during, and after cooling by using the proton resonance frequency method on a 3 T Siemens Magnetom Skyra system. ⋯ However, a large variability of the temperature drop was observed between the animals. This variability may be caused by not well-controlled factors confounding the MRI temperature mapping, for example, subject movement, or cooling effectiveness, for example, core temperature or nasal patency. The results indicate that the proposed high-flow cold air protocol allows for localized cooling of the frontal porcine brain, which may be clinically relevant for traumatic injuries of the frontal brain where systemic cooling is unfavorable.
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Ther Hypothermia Temp Manag · Mar 2018
The Effects of In-Hospital Intravenous Cold Saline in Postcardiac Arrest Patients Treated with Targeted Temperature Management.
Recent data suggest that rapid infusion of intravenous (IV) cold saline for Targeted Temperature Management (TTM) after cardiac arrest is associated with higher rates of rearrest, pulmonary edema, and hypoxia, with no difference in neurologic outcomes or survival when administered by Emergency Medical Services. We sought to determine the effects of IV cold saline administration in the hospital setting in postcardiac arrest patients to achieve TTM and its effect on clinical parameters and neurologic outcomes. ⋯ Infusion of IV cold saline is associated with shorter time to target temperature, increased incidence of pulmonary edema, and diuretic use, with no difference in cardiac rearrest, survival, and neurologic outcomes.