New study on therapeutic hypothermia.

[chbare]

http://www.nejm.org/doi/full/10.1056/NEJMoa1310519?query=featured_cardiology#t=articleTop

[BushyFromOz]

Saw that 3 or 4 days ago.. interesting aint it =D

[Kiwiology]

See here for the full, free article http://jama.jamanetwork.com/article.aspx?articleid=1778673

Yes, very interesting.

In hospital they use an ice blanket and get the patient much colder (to about 32 degrees).

I theorise that the relatively short time that pre-hospital people are with the patient (the vast majority would be < 30 minutes post ROSC) and isolated use of cold saline limits the benefit of something like this. While probably a little helpful, I am not sure if its practical to bring something more advanced into the pre-hospital space e.g. ice blanket or some sort of cutaneous based system, I know the London HEMS Doctors are using the Rhinochill nasal brain cooling system and a few places use ice packs.

These reasons are most likely why we haven't yet introduced active pre-hospital cooling in NZ i.e. no real evidence of benefit for the costs.

[chbare]

It makes a possible case not for aggressive cooling but for aggressive prevention of hyperpyrexia. Interesting and I wonder if this will change the AHA zeitgeist regarding hypothermia when 2015 comes around?

[Kiwiology]

I note there was a significant amount of pulmonary edema in these patients as well. Whilst my chemistry knowledge doesn't really extend to if there is any effect caused by the cold fluid, it certainly would seem like a less than good idea infusing a couple litres of fluid into somebody whose ticker probably ain't functioning too crash hot.