Abstract 155: Maintenance of Therapeutic Hypothermia During Routine Transport of Critically Ill Patients
Background: Following anoxic and hemorrhagic cerebral injury, therapeutic hypothermia (TH) is used as a neuroprotectant to improve neurological outcomes. These critically ill patients often need to be transported for diagnostic or interventional studies while undergoing TH. The need to transport ICU patients during TH was cited as a barrier to completion of the TH protocol, as additional personnel are required to transport an otherwise cumbersome cooling device. Using ice packs alone to maintain TH would likely improve compliance with protocols and minimize the need for additional resources during transport.
Objective: To determine if the use of ice packs without an external cooling device is sufficient to maintain TH for the duration of a routine transport in critically ill patients requiring diagnostic testing.
Methods: An observational study of intubated and sedated adult neurosurgical ICU patients who underwent TH (32-34°C) using an external cooling device but who were transported to diagnostic studies using ice packs placed bilaterally on the groin, axilla, and neck. Patients were excluded if temperature at time of transport was outside of this range or if pentobarbital was used for sedation. Patient demographics were collected. The amount of time spent during transport with ice packs was recorded. The change in rectal and cerebral temperatures during transport were recorded. Descriptive statistics were analyzed.
Results: 10 patients (6 female) with a mean age of 48.7±10.9 years and mean BMI of 30.3±6.2kg/m2 were entered into the study. Mean change in rectal temperature during transport using ice packs was -0.22±0.46°C (n=10, P=NS). Mean change in cerebral temperature during this time was -0.84±0.27°C (n=5, P=0.002). Mean time of transport was 39.6±22.7min (range 17-85 min).
Conclusion: The use of ice packs during transport to diagnostic studies is sufficient to maintain TH in critically ill patients. Using ice packs will minimize the need for additional resources during patient transport.
- © 2012 by American Heart Association, Inc.