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Cardiac arrest outcomes after targeted temperature management with an esophageal cooling device

Wayne, M. A.; Anderson, C.; Fisher, R.; Berry, D.; Diestelhorst, J. B.

2019-07-12 intensive care and critical care medicine
10.1101/19001487 medRxiv
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ObjectiveTo assess the efficacy of an esophageal device to provide TTM (Target Temperature Management) post Cardiac Arrest DesignA chart review of all patients treated with ETTM, following cardiac arrest. Initial patient temperature, time to target, supplemental methods (water blankets, head wraps, or ice packs), and patient survival were extracted for analysis. SettingCommunity Medical Center Intensive Care Unit PatientsAll patients receiving TTM via an esophageal device post Cardiac Arrest from August 2016 to November 2018 InterventionsTTM both cooling and warming via an esophageal device Measurements and ResultsA total of 54 patients were treated from August 2016 to November 2018; 30 received ETM only, 22 received supplemental cooling, and 2 had treatment discontinued prior to reaching target due to recovery. Target temperatures ranged from 32 to 36 degrees. The median time to target temperature for the entire cohort was 219 minutes (IQR 81-415). For the cohorts without, and with, supplemental cooling modalities, the median time to attain target temperature was 128 minutes (IQR 71-334), and 285 minutes (IQR 204-660), respectively. Survival to ICU discharge was 51.9% for the entire cohort. ConclusionsETM attains target temperature at a rate consistent with current guidelines and with similar performance to alternative modalities. This may provide a more cost-effective and approachable core cooling option to community hospitals that only use water blankets or other surface methods.

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