Francis Kim MD, Graham Nichol MD MPH, Charles Maynard PhD, Al Hallstrom PhD, Peter Kudenchuk MD, Thomas Rea MD, Michael Copass MD, David Carlbom MD Steven Deem MD, WT Longstreth Jr MD, Michele Olsufka RN, Leonard Cobb MD University of Washington Seattle, WA Randomized Clinical Trial of Pre-hospital Induction of Mild Hypothermia in Out-of-Hospital Cardiac Arrest Patients Using a Rapid Infusion of 4 o C Normal Saline
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Francis Kim MD, Graham Nichol MD MPH, Charles Maynard PhD ,
Randomized Clinical Trial of Pre-hospital Induction of Mild Hypothermia in Out-of-Hospital Cardiac Arrest Patients Using a Rapid Infusion of 4 o C Normal Saline. Francis Kim MD, Graham Nichol MD MPH, Charles Maynard PhD , Al Hallstrom PhD, Peter Kudenchuk MD, Thomas Rea MD, - PowerPoint PPT Presentation
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Francis Kim MD, Graham Nichol MD MPH, Charles Maynard PhD, Al Hallstrom PhD, Peter Kudenchuk MD, Thomas Rea MD,
Michael Copass MD, David Carlbom MDSteven Deem MD, WT Longstreth Jr MD, Michele Olsufka RN,
Leonard Cobb MD
University of WashingtonSeattle, WA
Randomized Clinical Trial of Pre-hospital Induction of Mild Hypothermia
in Out-of-Hospital Cardiac Arrest Patients Using a Rapid Infusion of 4oC
• Cold NS reduced core temperature by hospital arrival
• Use of cold NS associated with increased re-arrest during transport and increased transient pulmonary edema
• Lack of benefit of prehospital cooling consistent with previous smaller trial
• Prehospital cooling with cold NS did not improve survival or neurologic outcomes in patients with out-of-hospital VF or non-VF
Implications
• Cold fluid has associated risks• Study findings do not support routine
initiation of hypothermia using cold fluid in the prehospital setting
Paramedics in Seattle and King CountyHospitals: Harborview Medical Center, Swedish Medical Center, Virginia Mason Hospital,
UWMC, Northwest Hospital, Overlake Hospital, Valley Medical Center, Auburn General Hospital, St. Francis Hospital, Stevens Hospital.
DSMB: Chair: Kyra Becker, MD. Members: Margaret Neff, MD, Tina Chang, MD, Karl B. Kern, MD, Nancy Temkin, PhD, Ralph D’Agostino, PhD, Chief Earl Sodeman, Seattle Fire Department, Thomas Hearne, Michele Plorde, King County Public Health, Emergency Medical Services Division.
Study Nurses: Dianne K. Staloch, Karen Dong, Sue Scruggs, Alana C. Clark, Jane Edelson, Debi Solberg, Sally Ragsdale, Kathleen Fair, Barbara Ricker
Funding: NIH/NHLBI
Acknowledgements
F Kim and coauthors
Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With Cardiac Arrest: A Randomized Clinical Trial
Published online November 17, 2013
Available at www.jama.com and also at mobile.jamanetwork.com