Induction of therapeutic hypothermia during prehospital CPR using ice-cold intravenous fluid

Aim of the study: Primarily, to investigate induction of therapeutic hypothermia during prehospital cardiopulmonary resuscitation (CPR) using ice-cold intravenous fluids. Effects on return of spontaneous circulation (ROSC), rate of rearrest, temperature and haemodynamics were assessed. Additionally, the outcome was followed until discharge from hospital. Materials and methods: Seventeen adult prehospital patients without obvious external causes for cardiac arrest were included. During CPR and after ROSC, paramedics infused +4 degrees C Ringer's acetate aiming at a target temperature of 33 degrees C. Results: ROSC was achieved in 13 patients, 11 of whom were admitted to hospital. Their mean initial nasopharyngeal temperature was 35.17 +/- 0.57 degrees C (95% CI), and their temperature on hospital admission was 33.83 +/- 0.77 degrees C (-1.34 degrees C, p < 0.001). The mean infused volume of cold fluid was 1571 +/- 517 ml. The rate of rearrest after ROSC was not increased compared to previous reports. Hypotension was observed in five patients. Of the 17 patients, 1 survived to hospital discharge. Conclusion: Induction of therapeutic hypothermia during prehospital CPR and after ROSC using ice-cold Ringer's solution effectively decreased nasopharyngeal. temperature. The treatment was easily carried out and welt tolerated. (C) 2008 Elsevier Ireland Ltd. All rights reserved.