Schroeder, Daniel C., Maul, Alexandra C., Guschlbauer, Maria, Finke, Simon-Richard, Bethencourt, David de la Puente, Becker, Ingrid ORCID: 0000-0001-5829-3553, Padosch, Stephan A., Hohn, Andreas, Annecke, Thorsten ORCID: 0000-0002-2496-4432, Boettiger, Bernd W., Sterner-Kock, Anja and Herff, Holger (2019). Intravascular Cooling Device Versus Esophageal Heat Exchanger for Mild Therapeutic Hypothermia in an Experimental Setting. Anesth. Analg., 129 (5). S. 1224 - 1232. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 0003-2999

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Abstract

BACKGROUND: Targeted temperature management is a standard therapy for unconscious survivors of cardiac arrest. To date, multiple cooling methods are available including invasive intravascular cooling devices (IVDs), which are widely used in the clinical setting. Recently, esophageal heat exchangers (EHEs) have been developed providing cooling via the esophagus that is located close to the aorta and inferior vena cava. The objective was to compare mean cooling rates, as well as differences, to target temperature during maintenance and the rewarming period of IVD and EHE. METHODS: The study was conducted in 16 female domestic pigs. After randomization to either IVD or EHE (n = 8/group), core body temperature was reduced to 33 degrees C. After 24 hours of maintenance (33 degrees C), animals were rewarmed using a target rate of 0.25 degrees C/h for 10 hours. All cooling phases were steered by a closed-loop feedback system between the internal jugular vein and the chiller. After euthanasia, laryngeal and esophageal tissue was harvested for histopathological examination. RESULTS: Mean cooling rates (4.0 degrees C/h +/- 0.4 degrees C/h for IVD and 2.4 degrees C/h +/- 0.3 degrees C/h for EHE; P < .0008) and time to target temperature (85.1 +/- 9.2 minutes for IVD and 142.0 +/- 21.2 minutes for EHE; P = .0008) were different. Mean difference to target temperature during maintenance (0.07 degrees C +/- 0.05 degrees C for IVD and 0.08 degrees C +/- 0.10 degrees C for EHE; P = .496) and mean rewarming rates (0.2 degrees C/h +/- 0.1 degrees C/h for IVD and 0.3 degrees C/h +/- 0.2 degrees C/h for EHE; P = .226) were similar. Relevant laryngeal or esophageal tissue damage could not be detected. There were no significant differences in undesired side effects (eg, bradycardia or tachycardia, hypokalemia or hyperkalemia, hypoglycemia or hyperglycemia, hypotension, overcooling, or shivering). CONCLUSIONS: After insertion, target temperatures could be reached faster by IVD compared to EHE. Cooling performance of IVD and EHE did not significantly differ in maintaining target temperature during a targeted temperature management process and in active rewarming protocols according to intensive care unit guidelines in this experimental setting.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schroeder, Daniel C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maul, Alexandra C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guschlbauer, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Finke, Simon-RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bethencourt, David de la PuenteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becker, IngridUNSPECIFIEDorcid.org/0000-0001-5829-3553UNSPECIFIED
Padosch, Stephan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hohn, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Annecke, ThorstenUNSPECIFIEDorcid.org/0000-0002-2496-4432UNSPECIFIED
Boettiger, Bernd W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sterner-Kock, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herff, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-129866
DOI: 10.1213/ANE.0000000000003922
Journal or Publication Title: Anesth. Analg.
Volume: 129
Number: 5
Page Range: S. 1224 - 1232
Date: 2019
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 0003-2999
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TEMPERATURE MANAGEMENT; INDUCTIONMultiple languages
AnesthesiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/12986

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