Cold simple intravenous infusions preceding special endovascular cooling for faster induction of mild hypothermia after cardiac arrest—a feasibility study

Resuscitation ◽  
2005 ◽  
Vol 64 (3) ◽  
pp. 347-351 ◽  
Author(s):  
Andreas Kliegel ◽  
Heidrun Losert ◽  
Fritz Sterz ◽  
Matthias Kliegel ◽  
Michael Holzer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Feasibility Study ◽  
Mild Hypothermia ◽  
Intravenous Infusions ◽  
Endovascular Cooling

Shivering Management During Therapeutic Temperature Modulation: Nurses’ Perspective

2012 ◽  
Vol 32 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Mary Presciutti ◽  
Mary Kay Bader ◽  
Millie Hepburn
Keyword(s):  
Cardiac Arrest ◽  
Early Detection ◽  
Intravenous Infusion ◽  
Defense Mechanism ◽  
Mild Hypothermia ◽  
Temperature Modulation ◽  
Point Temperature ◽  
Subjective Assessments ◽  
Endovascular Cooling ◽  
Harmful Effects

Therapeutic temperature modulation, which incorporates mild hypothermia and maintenance of normothermia, is being used to manage patients resuscitated after cardiac arrest. Methods of modulating temperature include intravenous infusion of cold fluids and surface or endovascular cooling. During this therapy, the shiver response is activated as a defense mechanism in response to an altered set-point temperature and causes metabolic and hemodynamic stress for patients. Recognition of shivering according to objective and subjective assessments is vital for early detection of the condition. Once shivering is detected, treatment is imperative to avoid deleterious effects. The Bedside Shivering Assessment Scale can be used to determine the efficacy of interventions intended to blunt thermoregulatory defenses and can provide continual evaluation of patients’ responses to the interventions. Nurses’ knowledge and understanding of the harmful effects of shivering are important to effect care and prevent injury associated with uncontrolled shivering.

scholarly journals An observational study of surface versus endovascular cooling techniques in cardiac arrest patients: a propensity-matched analysis

Critical Care ◽  
2015 ◽  
Vol 19 (1) ◽  
pp. 85 ◽  
Author(s):  
Sang Oh ◽  
Joo Oh ◽  
Young-Min Kim ◽  
Kyu Park ◽  
Seung Choi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Observational Study ◽  
Surface Versus ◽  
Endovascular Cooling

scholarly journals Efficacy and Safety of Endovascular Cooling After Cardiac Arrest

Stroke ◽  
2006 ◽  
Vol 37 (7) ◽  
pp. 1792-1797 ◽  
Author(s):  
Michael Holzer ◽  
Marcus Müllner ◽  
Fritz Sterz ◽  
Oliver Robak ◽  
Andreas Kliegel ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Efficacy And Safety ◽  
Endovascular Cooling

Does the evidence support the use of mild hypothermia after cardiac arrest? Yes

BMJ ◽  
2011 ◽  
Vol 343 (sep22 2) ◽  
pp. d5830-d5830 ◽  
Author(s):  
J. P. Nolan ◽  
J. Soar
Keyword(s):  
Cardiac Arrest ◽  
Mild Hypothermia

scholarly journals Mild hypothermia after cardiac arrest in dogs does not affect postarrest multifocal cerebral hypoperfusion.

Stroke ◽  
1993 ◽  
Vol 24 (10) ◽  
pp. 1590-1597 ◽  
Author(s):  
K Oku ◽  
F Sterz ◽  
P Safar ◽  
D Johnson ◽  
W Obrist ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Mild Hypothermia ◽  
Cerebral Hypoperfusion

scholarly journals Our experiences with therapeutic hypothermia

2007 ◽  
Vol 60 (9-10) ◽  
pp. 431-435 ◽  
Author(s):  
Milovan Petrovic ◽  
Ilija Srdanovic ◽  
Gordana Panic ◽  
Tibor Canji ◽  
Tihomir Miljevic
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Neurological Outcome ◽  
Mild Hypothermia ◽  
Acute Myocarditis ◽  
Neuroprotective Effect ◽  
Sudden Cardiac Arrest ◽  
Neurological Recovery ◽  
Global Cerebral Ischemia ◽  
Resuscitation Guidelines

Introduction. The single most important clinically relevant cause of global cerebral ischemia is cardiac arrest. The estimated rate of sudden cardiac arrest is between 40 and 130 cases per 100.000 people per year. Almost 80% of patients initially resuscitated from cardiac arrest remain comatose for more than one hour. One year after cardiac arrest only 10-30% of these patients survive with good neurological outcome. The ability to survive anoxic no-flow states is dramatically increased with protective and preservative hypothermia. The results of clinical studies show a marked neuroprotective effect of mild hypothermia in resuscitation. Material and Methods. In our clinic, 12 patients were treated with therapeutic hypothermia. A combination of intravascular and external method of cooling was used according to the ILCOR (International Liaison Committee on Resuscitation) guidelines. The target temperature was 33oC, while the duration of cooling was 24 hours. After that, passive rewarming was allowed. All patients also received other necessary therapy. Results. Six patients (50%) had a complete neurological recovery. Two patients (16.6%) had partial neurological recovery. Four patients (33.3%) remained comatose. Five patients (41.66%) survived, while 7 (58.33%) patients died. The main cause of cardiac arrest was acute myocardial infarction (91.6%). One patient had acute myocarditis. Conclusion. Mild resuscitative hypothermia after cardiac arrest improves neurological outcome and reduces mortality in comatose survivors. .

Induced Moderate Hypothermia After Cardiac Arrest

2009 ◽  
Vol 20 (4) ◽  
pp. 343-355
Author(s):  
Staci McKean
Keyword(s):  
Cardiac Arrest ◽  
Best Practice ◽  
Mild Hypothermia ◽  
Head Injuries ◽  
Heart Association ◽  
Spontaneous Circulation ◽  
Moderate Hypothermia ◽  
Induced Hypothermia ◽  
Nursing Management ◽  
Hospital Cardiac Arrest

The use of induced hypothermia has been considered for treatment of head injuries since the 1900s. However, it was not until 2 landmark studies were published in 2002 that induced hypothermia was considered best practice for patients after cardiac arrest. In 2005, the American Heart Association included recommendations in the postresuscitation support guidelines recommending consideration of mild hypothermia for unconscious adult patients with return of spontaneous circulation following out-of-hospital cardiac arrest due to ventricular fibrillation. This article provides an overview on the history and supportive research for inducing mild hypothermia after cardiac arrest, the pathophysiology associated with cerebral ischemia occurring with hypothermia, nursing management for this patient population, and the development of a protocol for induced hypothermia after cardiac arrest.

Mild hypothermia cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs

1991 ◽  
Vol 19 (3) ◽  
pp. 379-389 ◽  
Author(s):  
FRITZ STERZ ◽  
PETER SAFAR ◽  
SAMUEL TISHERMAN ◽  
ANN RADOVSKY ◽  
KAZUTOSHI KUBOYAMA ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Mild Hypothermia
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