Andrej Markota1, Jure Fluher2, Barbara Kit2, Petra Balažič2, Andreja Sinkovič3. 1. 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. 2. Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia. 3. 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.
Abstract
BACKGROUND: Temperature 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. METHODS: We 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 FINDINGS: A 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. CONCLUSION: Using 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.
BACKGROUND: Temperature 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. METHODS: We 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 FINDINGS: A 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. CONCLUSION: Using 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.
Authors: Marcela Mercado Montoya; Steven Mickelsen; Brad Clark; Martin Arnold; Joseph Hanks; Eric Sauter; Erik Kulstad Journal: J Atr Fibrillation Date: 2019-02-28
Authors: Melissa I Naiman; Maria Gray; Joseph Haymore; Ahmed F Hegazy; Andrej Markota; Neeraj Badjatia; Erik B Kulstad Journal: J Vis Exp Date: 2017-11-21 Impact factor: 1.355
Authors: Daniel C Schroeder; Maria Guschlbauer; Alexandra C Maul; Daniel A Cremer; Ingrid Becker; David de la Puente Bethencourt; Peter Paal; Stephan A Padosch; Wolfgang A Wetsch; Thorsten Annecke; Bernd W Böttiger; Anja Sterner-Kock; Holger Herff Journal: PLoS One Date: 2017-03-14 Impact factor: 3.240