cooling/heating w/ CVC setups

[MrBubbles]

I just had my first experience with a femoral CVC that has the ability to heat or cool the pt. I'm under the impression that they are usually used to induce hypothermia post MI to reduce metabolic demand on the heart. Or of course heating a pt who is very hypothermic. My concern is learning about the effects on hemodynamics and electrolytes when doing this. One RN did state that when bringing a pt back from hypothermia and heating them back up, the pt just went to crap fast. So I want to get educated on what exactly I need to be able to anticipate when heating or cooling these pts so as to prevent disaster. Any info is appreciated.

[Bubbles_RN]

No personal experience with using a line - we use a traditional cooling blanket to cool our post arrest pts......but here is my experiences with complications:

Cooling - I've had a couple of pts who ended up being too cold, and developed symptomatic bradycardias. We treated with a bit of dopmanine while warming them to the intended temps

Warming - we aim for a degree every 4 hours, so a very gentle re-warm. I've had one pt. develop hyperkalemia, which we caught early, and one who develped f-fib as soon as he got into the 35 degree range (sorry canadian used to C) that just had such extensive cardiac damage he couldn't deal with the increased metabolic demands.