Prehospital induction of therapeutic hypothermia during CPR: a pilot study.

Abstract

We studied induction of therapeutic hypothermia during prehospital resuscitation from cardiac arrest using an infusion of ice-cold Ringer's solution in five adult patients. Paramedics infused +4 degrees C Ringer's solution into the antecubital vein of the patients with a maximum rate of 33 ml/min to a target temperature of 33.0 degrees C. The mean infused volume of cold fluid was 14.0 ml/kg, which resulted in a mean decrease of 2.5 degrees C in nasopharyngeal temperature. The decrease in temperature continued after the cessation of infusion in two patients, causing suboptimal temperatures below 32 degrees C. We conclude that the infusion of small volumes of ice-cold Ringer's solution during resuscitation results in an effective decrease in nasopharyngeal temperature. Caution should be taken to avoid temperatures below the range of mild therapeutic hypothermia.