Surface Cooling Vs.

Intravascular cooling

Surface Cooling Cheaper Methods Fans Ice Ambient Water Other Blanket Devices Anyone Can do it .

Limitations of Surface Cooling • Limits access to patient (surface cooling) • Nurse intensive / wet surface poses risk (ice/lavage/cooling blanket) • Difficulty during target temp maintenance – overshoot • Uncontrolled rewarming – rebound ICP and hyperthermia • Increased shivering (surface cooling) • Rolling patient to place additional cooling on the back poses risk (cooling pad/blanket) .

Treatment Modalities • It is important to switch from external cooling as soon as feasible Cooling using external ice packs University of Chicago 2003-2004 Study .

Lance B. MD. MD: Therapeudic Hypothermia After Cardiac Arrest: Unintentional Overcooling is Common Using Ice Packs and Conventional Cooling Blankets. MD. No. MD. Crit Care Med 2006 Vol. Jasmeet Soar.. Ong. Merchant. MPH. MD MPhil' Mary Ann Peberdy. MD. Abella.e electrical shocks and anti-arrhythmic therapies 21% Rebound Fever Temperature below 30ºC Temperature below 31ºC References Raina M. Gregory A. 44% 35% Resulting in: • • • • Atrial or ventricular arrhythmias Coagulopathy Increased risk of infection Interference with resuscitation. H.. marcus E.Nurses have a 63% chance of overcooling their patients when using surface cooling methods Controlled Surface Cooling Overcooling 37% 63% Of that 63%. Becker. MBBS. 12 . MD. Vanden Hoek. i... Schmidt. Terry L. Benjamin S. 34.

Merchant. MBBS. Schmidt. MD. Not Overcooling Overcooling Survival Death Not Overcooling Survival 30% Death 58% 70% 42% References Raina M. MD MPhil' Mary Ann Peberdy.Death Rate: Overcooling vs. No. 12 . MPH. Vanden Hoek. Lance B. Ong. Benjamin S. MD. MD. marcus E. 34. MD: Therapeudic Hypothermia After Cardiac Arrest: Unintentional Overcooling is Common Using Ice Packs and Conventional Cooling Blankets. Becker. Abella. MD. H. Jasmeet Soar. Crit Care Med 2006 Vol. Terry L. Gregory A. MD.

Better Temperature Management = Better Medicine HACA Trial N = 275 Alsius’ Icy Trial N = 86 60% 55% Six Month Results Mortality 41% 40% 29% 20% 0% Control Surface Cooling Intravascular Cooling Time to Target Temperature Holzwe M. et al Stroke. July 2006 . Sterz F.

quick disconnect when patient moves within hospital • Control and accuracy of temperature maintenance is superior • Controlled rate of rewarming • Manages rebound hyperthermia post-hypothermia procedure up to 4 or 7 days .Advantages of Intravascular Cooling • • • • • • Easy to initiate therapy Does not interfere with patient access/care activities No thermal injury worries Reduced shivering compared with surface cooling Central venous access Easy.

Clinical Applications Where ALSIUS Intravascular Temperature Management Has Been Used For Cooling • • • • • • • • • • • Fever control in Neuro/Surgical ICU Therapeutic hypothermia after cardiac arrest ICP (intracranial pressure) management Therapeutic hypothermia for brain trauma and stroke Acute liver failure Adjunct with interventional procedure Malignant hyperthermia Heat stroke Spinal cord injury Spinal surgery Adjunct with hemicraniectomy .

Clinical Applications Where ALSIUS Intravascular Temperature Management Has Been Used For Warming • • • • Trauma victims Accidental hypothermia Burn surgery and intensive care Cardiac surgery – OPCAB (off-pump coronary artery bypass) – Post-bypass pump (prevention of after-drop) • • Thoracic aneurysm surgery Maintain viable donor organs for transplantation .

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