Prehospital induction of therapeutic hypothermia during CPR: A pilot study

Summary Aim of the study 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. Material and methods Paramedics infused +4 °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 °C. Results The mean infused volume of cold fluid was 14.0 ml/kg, which resulted in a mean decrease of 2.5 °C in nasopharyngeal temperature. The decrease in temperature continued after the cessation of infusion in two patients, causing suboptimal temperatures below 32 °C. Conclusion 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.