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Randomized Controlled Trial
. 2010 Jan;81(1):9-14.
doi: 10.1016/j.resuscitation.2009.09.015. Epub 2009 Oct 24.

A randomized controlled trial comparing the Arctic Sun to standard cooling for induction of hypothermia after cardiac arrest

Kennon J Heard  1 , Mary Ann Peberdy, Michael R Sayre, Arthur Sanders, Romergryko G Geocadin, Simon R Dixon, Todd M Larabee, Katherine Hiller, Albert Fiorello, Norman A Paradis, Brian J O'Neil
Affiliations
Randomized Controlled Trial

A randomized controlled trial comparing the Arctic Sun to standard cooling for induction of hypothermia after cardiac arrest

Kennon J Heard et al. Resuscitation. 2010 Jan.

Abstract

Context: Hypothermia improves neurological outcome for comatose survivors of out-of-hospital cardiac arrest. Use of computer controlled high surface area devices for cooling may lead to faster cooling rates and potentially improve patient outcome.

Objective: To compare the effectiveness of surface cooling with the standard blankets and ice packs to the Arctic Sun, a mechanical device used for temperature management.

Design, setting, and patients: Multi-center randomized trial of hemodynamically stable comatose survivors of out-of-hospital cardiac arrest.

Intervention: Standard post-resuscitative care inducing hypothermia using cooling blankets and ice (n=30) or the Arctic Sun (n=34).

Main outcome measures: The primary end point was the proportion of subjects who reached a target temperature within 4h of beginning cooling. The secondary end points were time interval to achieve target temperature (34 degrees C) and survival to 3 months.

Results: The proportion of subjects cooled below the 34 degrees C target at 4h was 71% for the Arctic Sun group and 50% for the standard cooling group (p=0.12). The median time to target was 54 min faster for cooled patients in the Arctic Sun group than the standard cooling group (p<0.01). Survival rates with good neurological outcome were similar; 46% of Arctic Sun patients and 38% of standard patients had a cerebral performance category of 1 or 2 at 30 days (p=0.6).

Conclusions: While the proportion of subjects reaching target temperature within 4h was not significantly different, the Arctic Sun cooled patients to a temperature of 34 degrees C more rapidly than standard cooling blankets.

Trial registration: ClinicalTrials.gov NCT00282373.

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Figures

Figure 1
Figure 1
Time to achieve a core temperature <34 °C for patients cooled with the Arctic Sun and standard cooling methods.
Figure 2
Figure 2
Patient temperatures during induction, cooling and rewarming for Arctic Sun (AS) and water blanket (WB).
See this image and copyright information in PMC

References

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