Hypothermia post cardiac arrest

allnurses Guide · Sep 30, 2008

My previous hospital in Australia is currently completing a trial of hypothermia post cardiac arrest. We used the arctic sun cooling product, and an IDC temperature probe.

An interesting presentation by the PI of our study: http://sccmwww.sccm.org/documents/Con07/Monday/M705a%20Bernardr.pdf

Some articles about it from the Arctic Sun manufacturer website: http://www.medivance.com/html/clinical/ResRef_ASPubs.html

ham2001 · Sep 30, 2008

We used this as a small study at Ohio State I don't remember the manufacturer.

Without the available interventional lab this is I feel a valid alternative, but the bottom line I still feel is that time is muscle and all this allows is more time with less muscle damage. Fix the problem and you don't have to be concerned with this as a form of treatment!

nightshift82 · Sep 30, 2008

I agree the best to open the culprit vessel or vessels. I'm not sure of the number of patients that may benefit but even if it's only 5/year, it may make a difference for those five. I thought AHA supported this as a tx. I will have to look into that further. Thanks for the information.:wink2:

nightshift82 · Sep 30, 2008

Thanks to "ghillbert" for the info and the website:wink2:

allnurses Guide · Oct 1, 2008

You're welcome. Also keep in mind that "cardiac arrest" is not only related to ischemic cardiac vessels - I can think of one boy we enrolled in the trial, 23yo who hit his head on the curb outside a nightclub, had a respiratory arrest, then cardiac arrest.

If you check out the PPT I posted a link to, it states that the "AHA recommend therapeutic hypothermia after VF arrest, consider in non-VF arrest".

A lot of morbidity after cardiac arrest involves the cerebral insult, so active cooling should theoretically improve this.

nightshift82 · Oct 1, 2008

Great! Thanks for your help:wink2:

JustMe · Oct 1, 2008

A friend of mine actually did a study of this at a hospital in Reno, NV. It was written up in an AACN journal but I can't seem to access it at the moment. I'll keep looking.

Pinto · Oct 2, 2008

We have an up and runnung protocol for the induction of hypothermia. Here is a link to the device we are currently using.

http://www.medivance.com/

nightshift82 · Oct 2, 2008

Thanks for the information. It looks like the same system the "ghillbert" uses. The system looks to have ease of use and I like the fact that you can fluro through the pads also.:)

deeDawntee, RN · Oct 2, 2008

The hypothermia protocol, in my understanding, is primarily to preserve brain function. We use it often in my facility. Just this week, a pt was post cardiac arrest, in a coma, and pupils were non-responsive, no gag or cough reflex...you get the picture. After an EEG, and echo, the docs determine that this pt was a canditate for hypothermia. The intention is to slow down any metabolic processes that may cause more brain damage. We give Vecuronium to prevent shivering, as that is stressful for the body. We use the Arctic Sun which both cools the pt. slowly over 12 hours (our protocol is to 33 C for 24 hours) and then rewarms them slowly over 12 hours. So, the whole process takes 48 hours. (we use a bladder temp) We have seen true 'miraculous' recoveries, where people do regain brain function. It is amazing that it is just a simple concept that can be life saving.

Very, very cool.....(pun intended) :p:rolleyes:

JustMe · Oct 2, 2008

Found the article but it describes more the role of the clinical nurse specialist:

http://ccn.aacnjournals.org/cgi/reprint/27/5/36.pdf