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Devices for rapid induction of hypothermia

Published online by Cambridge University Press:  01 February 2008

M. Holzer
M. Holzer*
Affiliation:
Medical University of Vienna, Department of Emergency Medicine, Vienna, Austria
*
Correspondence to: Michael Holzer, Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, A-1090 Vienna, Austria. E-mail: michael.holzer@meduniwien.ac.at; Tel: +43 1 40400 1964; Fax: +43 1 40400 1965; Mobile: +43 664 2632869
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Summary

In industrial countries it is estimated that the incidence of out-of-hospital sudden cardiac arrest lies between 36 and 128 per 100 000 inhabitants per year. Almost 80% of patients who initially survive a cardiac arrest present with coma lasting more than 1 h. Current therapy during cardiac arrest concentrates on the external support of circulation and respiration with additional drug and electrical therapy. Therapeutic hypothermia provides a new and very effective therapy for neuroprotection in patients after cardiac arrest. It is critical that mild hypothermia has to be applied very early after the ischaemic insult to be effective, otherwise the beneficial effects would be diminished or even abrogated. There are numerous methods available for cooling patients after ischaemic states. Surface cooling devices are non-invasive and range from simple ice packs to sophisticated machines with automatic feedback control. Other non-invasive methods include drugs and cold liquid ventilation. The newer devices have cooling rates comparable to invasive catheter techniques. Invasive cooling methods include the administration of ice-cold fluids intravenously, the use of intravascular cooling catheters, body cavity lavage, extra-corporeal circuits and selective brain cooling. Most of these methods are quite invasive and are still in an experimental stage. The optimal timing and technique for the induction of hypothermia after cardiac arrest have not yet been defined, and it is currently a major topic of ongoing research. The induction of hypothermia after cardiac arrest needs to be an integral component of the initial evaluation and stabilization of the patient.

Keywords

CARDIAC ARRESTHYPOTHERMIAEQUIPMENT AND SUPPLIESOUTCOME
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 31 - 38
Copyright
Copyright © European Society of Anaesthesiology 2008

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