Surface cooling after cardiac arrest: effectiveness, skin safety, and adverse events in routine clinical practice.

BACKGROUND: Effectiveness of cooling and adverse events (AEs) involving skin have not been intensively evaluated in cardiac arrest survivors treated with therapeutic hypothermia (TH) when induced and maintained with a servomechanism-regulated surface cooling system. METHODS: Retrospective review of...

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Bibliographic Details
Main Authors: Jarrah, Salam, Dziodzio, John, Lord, Christine, Fraser, Gilles L, Lucas, Lee, Riker, Richard R, Seder, David B
Format: Text
Language:unknown
Published: MaineHealth Knowledge Connection 2011
Subjects:
Aged
Body Mass Index
Equipment Design
Equipment Safety
Female
Heart Arrest
Humans
Hypothermia
Induced
Male
Middle Aged
Pressure Ulcer
Retrospective Studies
Risk Factors
Skin
Treatment Outcome
Endocrinology
Diabetes
and Metabolism
Patient Safety
Arctic
Online Access:https://knowledgeconnection.mainehealth.org/mmc/2182
https://pubmed.ncbi.nlm.nih.gov/21249528/
Description
Summary:BACKGROUND: Effectiveness of cooling and adverse events (AEs) involving skin have not been intensively evaluated in cardiac arrest survivors treated with therapeutic hypothermia (TH) when induced and maintained with a servomechanism-regulated surface cooling system. METHODS: Retrospective review of sixty-nine cardiac arrest survivor-events admitted from April 2006-September 2008 who underwent TH using the Medivance Arctic Sun Temperature Management System. A TH database and medical records were reviewed, and nursing interviews conducted. Primary endpoint was time from initiation to target temperature (TT; 32-34 °C). Secondary endpoints were cooling rate, percentage of hypothermia maintenance phase at TT, effect of body-mass index (BMI) on rate of cooling, and AEs. RESULTS: Mean time to the target temperature (TT) was 2.78 h; 80% of patients achieved TT within 4 h; all did within 8 h. Patients were at TT for 96.7% of hypothermia maintenance; 17% of patients had >1 hourly temperature measurement outside TT range. Mean cooling rate during induction phase was 1.1 °C/h, and was not associated with BMI. Minor skin injury occurred in 14 (20%) patients; 4 (6%) were device-related. Skin injuries were associated with shock (P = 0.04), and decubitus ulcers were associated with left ventricular ejection fraction CONCLUSIONS: The Arctic Sun Temperature Management System was an effective means of performing therapeutic hypothermia after cardiac arrest. Infrequent skin injuries were associated with vasopressor use and low ejection fraction.

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