Induction of prehospital therapeutic hypothermia after resuscitation from nonventricular fibrillation cardiac arrest

Stephen Anthony Bernard, Karen Smith, Peter Cameron, Kevin Masci, David McD Taylor, David James Cooper, Anne-Maree Kelly, William Silvester

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To evaluate the effects on temperature and outcome at hospital discharge of a pre-hospital rapid infusion of large volume, ice-cold intravenous Hartmann?s solution in patients with out-of-hospital cardiac arrest and an initial cardiac rhythm of asystole or pulseless electrical activity. Design: Prospective, randomized, controlled clinical trial. Setting: Pre-hospital emergency medical service and 12 critical care units in Melbourne, Australia. Patients: One hundred and sixty three patients who had been resuscitated from cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity. Interventions: Patients were randomized to either pre-hospital cooling using a rapid infusion of up to two litres ice-cold Hartmann?s solution (82 patients) or cooling after hospital admission (81 patients). The planned duration of therapeutic hypothermia (32?C?34?C) in both groups was 24 hrs. Measurements and Main Results: Patients allocated to prehospital cooling received a median of 1500 ml of ice-cold fluid. This resulted in a mean decrease in core temperature of 1.4?C compared with 0.2?C in hospital cooled patients (p <.001). The time to therapeutic hypothermia (
Original languageEnglish
Pages (from-to)747 - 753
Number of pages7
JournalCritical Care Medicine
Issue number3
Publication statusPublished - 2012

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