Abstract 34: Efficacy and Safety of a Novel Rapid Non-invasive Surface Cooling Device for Induction of Therapeutic Hypothermia in Patients after Cardiac Arrest
Background: Therapeutic hypothermia after cardiac arrest improves neurologic recovery and mortality. Rapid induction of therapeutic hypothermia might further improve neurologic outcome after cardiac arrest. The safety and effectiveness of the Thermosuit® System was assessed in survivors of cardiac arrest.
Methods: Eight patients who have been successfully resuscitated from cardiac arrest were included in a prospective observational case series at an emergency department of a tertiary care university hospital. Patients were surface cooled with ice cold water circulating in the device (Thermosuit® System, Life Recovery Systems, Kinnelon, USA) until a target esophageal temperature of 34.5°C was achieved. Further they were kept at a temperature between 32 and 34 °C for 12 hours by external surface cooling or warming and were then passively rewarmed. Results are presented with median and interquartile range.
Results: The age of the patients was 63 (48 – 69), there were 7 male patients, the body mass index was 26.1 (24.7–27.7) kg/m2, the time from cardiac arrest to ROSC was 18.5 (15.5–34.5) min. The esophageal temperature immediately before start of cooling was 36.2 (35.1–36.9). The patients were cooled with the device for 37 (24–51) min and a temperature of 34°C was reached after 44 (30 – 60) min. This led to a cooling rate of 3.0 (1.9 –3.5) °C/h. In 4 patients additional warming and in 3 patients additional cooling was needed during the maintenance phase. Seven patients (88%) were successfully discharged from the hospital. The NIH stroke scale at discharge was 0 (0 – 4.3) and the Mini Mental score was 29.5 (23–30). A total of 5 serious adverse events (ventricular fibrillation, pneumonia, sepsis) and 7 adverse events occurred in the 8 patients. No adverse event was related to the cooling device.
Conclusions: The Thermosuit® System was safe and highly effective in inducing therapeutic hypothermia in patients after cardiac arrest. The vast majority of the survivors had excellent neurologic performance scores at hospital discharge.