부산대학교 도서관

Introduction Induction of mild hypothermia after cardiac arrest may confer neuroprotection. We assessed the feasibility, safety and effectiveness of therapeutic infusion of 2 l of normal saline at 4[degrees]C before return of spontaneous circulation during cardiopulmonary resuscitation after out of hospital cardiac arrest. Methods This was a prospective, observational, multicenter clinical trial conducted in Emergency Medical Services units and in a medical intensive care unit at Caen University Hospital, Cen, France. Results In patients who had suffered out of hospital cardiac arrest, hypothermia was induced by infusing 2 l of 4[degrees]C NaCl 0.9% over 30 minutes during advanced life support prior to arrival at the hospital. A total of 33 patients were included in the study. Eight patients presented with ventricular fibrillation as the initial cardiac rhythm. Mild hypothermia was achieved after a median of 16 minutes (interquartile range 11.5 to 25.0 minutes) after return of spontaneous circulation. After intravenous cooling, the temperature decreased by 2.1[degrees]C (P [less than] 0.0001) to a mean body temperature of 33.3[degrees]C (interquartile range 32.3 to 34.3[degrees]C). The only observed adverse event was pulmonary oedema, which occurred in one patient. Conclusion We concluded that prehospital induction of therapeutic hypothermia using infusion of 2 l of 4[degrees]C normal saline during advanced life support was feasible, effective and safe. Larger studies are required to assess the impact that this early cooling has on neurological outcomes after cardiac arrest.
Authors: Cedric Bruel (corresponding author) [1]; Jean-Jacques Parienti [2]; William Marie [1]; Xavier Arrot [3]; Cedric Daubin [1]; Damien Du Cheyron [1]; Massimo Massetti [4]; Pierre Charbonneau [1] Introduction Out [...]