Prehospital induction techniques: mild hypothermia during advanced life support

Abstract

The use of therapeutic hypothermia has been proposed as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. This article aims to explore the different techniques used to induce hypothermia during prehospital cardiovascular arrest. The review of the necessary literature has been made in order to answer the question ‘What are the possible cooling methods to reach therapeutic hypothermia in out-of-hospital cardiac arrest?’. The research took place between May–November 2008. Ovid database was examined/questioned initially and the research was carried out simultaneously using Ovid Medline, Pubmed and CINAHL. The research showed that inclusion and exclusion criteria were similar in all the analysed studies. The chosen patients were aged 18–70 years. Only one article included patients older than 70 years who were affected by extra-hospital cardiocirculatory arrest and were treated with therapeutic hypothermia with infusion of cold liquids or use of correspondent remedies. A total of 627 620 articles were found during the search term research. Boolean operators were used to review the research. ‘AND’ was used to combine to the operator limit. ‘OR’ was used to include orthographic alternatives. All this reduced the research to four articles. Cutting off and mesh researches were used in ‘include relative terms’ within the Ovid control panel. The analysis of the four studies showed the effectiveness of introducing hypothermia in prehospital treatment dealing with the reduction of the oesophageal temperature. In all studies, the temperature reduction is relevant, presenting values of −1–4°C. The infusion of cold solutions is a technique that is easy to apply and has low costs. Infusion with cold pads, on the other hand, proves more difficult and requires greater attention and daily maintenance.