Abstract 125: Intraosseous Infusion of Ice Cold Saline is Less Effective than Intravenous Infusion for Induction of Mild Therapeutic Hypothermia in a Swine Model of Cardiac Arrest
Introduction: Intravenous (IV) infusion of ice cold saline is an effective method for induction of mild therapeutic hypothermia (MTH) following resuscitation from out-of-hospital cardiac arrest (OOHCA). Intraosseous (IO) infusion of cold saline may be an alternative method to induce MTH.
Objective: The goal of this study was to determine if IO infusion of cold saline is a comparable alternative to IV infusion for inducing MTH in a laboratory swine model of cardiac arrest.
Methods: Ten mixed breed swine were resuscitated from cardiac arrest and randomized post-resuscitation to infusion with ice cold saline using either IO (n=5) or IV (n=5) access. The study endpoints were a goal temperature of 34°C as measured by an esophageal temperature probe, or a 30 minute time period had elapsed simulating a long prehospital transport time.
Results: 4/5 pigs in the IV infusion group achieved goal temperature within 30 minutes compared to 0/5 in the IO infusion group (p=0.048). The mean esophageal temperature change was significantly higher in the IV group when compared to the IO group (p<0.001). Post-arrest hemodynamic parameters were the same between the two groups.
Conclusions: IV infusion of ice cold saline is a more effective method to achieve MTH in the post-arrest setting. IO infusion of cold saline is not sufficient to achieve MTH in the time routinely available in the prehospital setting in this animal model of cardiac arrest. IO infusion may serve as a backup method to begin the cooling process if IV access cannot be established.
- © 2010 by American Heart Association, Inc.