thanks, what brand are the blankets. Is it possible to set a temperature or os it just on/off?
You can use Ringer's lactate or Normal Saline kept in a refrigerator to cool your patients. I think, internal cooling through IV fluids is faster than outer cooling devices as many of these patients have poor peripheral perfusion and may take longer time to cool the brain, that we are trying to save. It is cost effective, controllable and easily available. :)
Crit Care Clin. 2012 Apr;28(2):231-43. doi: 10.1016/j.ccc.2011.10.012. Epub 2011 Dec 1.
Therapeutic hypothermia after cardiac arrest in adults: mechanism of neuroprotection, phases of hypothermia, and methods of cooling.
Weng Y1, Sun S.
In in hospital cardiac arrest we use 4°C Cristalloids 30 ml/kg if other strategies are not available. If requested by emodinamic asset, hypothermia may be achieved with VA ECMO. We found very feasible and without side effects irrigation of stomach and bladder with frozen free water. We had experiences also with Rhinochill (very interesting because allow to refrigerate patient with ongoing CPR) and Artic Sun blankets (slower than other methods but fully efficient!!). Rhinochill appear to be more indicated for prehospital and emergency room setting, while arctic sun needs to be placed in intensive care unit, after the diagnostic phase.
We use the ZOLL Temperature Managmenet System CoolGuardTM. It is an invasive device like a normal mulit-lumen central venous line plus a cooling chamber arround the catheter. It is easy to use, provides a good temperature control including controlled cooling- ans rewarming-period. During critical care you need usually a central venous acces line so it is no additional device. Further more you have full acces to the body for other purposes.
Negative: more expensive than other cooling methods. You need the "Quattro-Catheter" for fast cooling within the recommended time-frame after ROSC.
If you have to rewarm a patient from severe hypothermia (< 30°C BCT) you need a good cardiac output, otherwise you have to establish an ECMO with all possible side-effects.
Hi Oliver
We don't cool after resuscitation in the neonatal world. However, we do use therapeutic hypothermia in our perinatal asphyxiated infants. The machine that we use is the CritiCool cooling device, it is fully automated for cooling and rewarming.
Cheers James
Hi Oliver: We use the Blanketrol II, initially with two waterblankets and when target temperature is reached we remove the blanket underneath the patient. We use the bladdertemperature to guide te Blanktrol II.
Pro: cheap, reusable blankets (disposables are available)
Con: uncomfortable, we have seen pressure ulcers with 24H cooling with two mattresses, temperature management too slow (afterdrop to temperatures < 32C), patient is very cold on the outside wich is very impressive for the family of the patient
Kind regards: Paul.
Looks like this may be a duplicate question here. I've added some additional thoughts on the other posting.
https://www.researchgate.net/post/What_kind_of_cooling_devices_do_you_use_to_cool_patients_after_resuscitation#55f99fef5cd9e3f2408b4643
https://www.researchgate.net/post/What_kind_of_cooling_devices_do_you_use_to_cool_patients_after_resuscitation#55f99fef5cd9e3f2408b4643
Hi Oliver, our experience in cooling of the patients with TCA ( total circulatory arrest) in Aortic Arch surgery are balnket and ice application on head of the patients with target core temperature 18 - 20 degree of centigrade. All patients had dilated pupils during TCA which return to mid size pupils with slow rewarming. All the patients awaked without problem
Best regard.
- Badges
- Science topic
- Similar topics
- Geoscience
- Asia
- India