Heat/cool w/ CVC?

[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.

[TakeBack]

Warming after hypothermia causes vasodilation of peripherally constricted tissue vascular beds, and resultant hypotension.

Use of volume loading and tone agents (phenylephrine, vasopressin) can help.

[AmyCardsNP, RN, NP]

We induce hypothermia on patients post witnessed cardiac arrest using external blankets. The way I've often seen patients "go to crap" during the rewarming phase is resultant from electrolyte shifts. We don't replace potassium during the 8 hours prior to rewarming for this exact reason. You can expect to see many arrhythmias.

[Zookeeper3]

Refractory VF when they're very cold is "common"... shock, shock, shock. Used to work in NY where we'd get the crazy drunks who passed out in the snow. We'd code them forever through many crash carts, they usually came back intact. When we keep our post arrests very hypothermic, you never know the VF trigger point of these guys, so be prepared and when it's time to re-warm, nice and slow!