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Comparative Study
. 2011 May;82(5):603-6.
doi: 10.1016/j.resuscitation.2011.01.007. Epub 2011 Feb 22.

Intraosseous infusion of ice cold saline is less efficacious than intravenous infusion for induction of mild therapeutic hypothermia in a swine model of cardiac arrest

Todd M Larabee  1 , Jenny A Campbell, Fred A Severyn, Charles M Little
Affiliations
Comparative Study

Intraosseous infusion of ice cold saline is less efficacious than intravenous infusion for induction of mild therapeutic hypothermia in a swine model of cardiac arrest

Todd M Larabee et al. Resuscitation. 2011 May.

Abstract

Background: Intravenous (IV) infusion of ice cold saline is an effective method to initiate induction of mild therapeutic hypothermia (MTH) following resuscitation from out-of-hospital cardiac arrest (OOHCA). Intraosseous (IO) infusion of cold saline may be an alternative method to induce MTH.

Objective: The goal of this study was to determine if IO infusion of cold saline is a comparable alternative to IV infusion for inducing MTH in a laboratory swine model of cardiac arrest.

Methods: Ten mixed breed swine were resuscitated from cardiac arrest and randomized post-resuscitation to infusion with ice cold saline using either IO (n = 5) or IV (n = 5) access. The study endpoints were either a goal esophageal temperature of 34 °C or the elapse of a 30 min time period, simulating a long prehospital transport.

Results: Four of five pigs in the IV infusion group achieved goal temperature within 30 min compared to 0/5 in the IO infusion group (p = 0.048). The mean esophageal temperature change was significantly higher in the IV group when compared to the IO group (p < 0.001). Post-arrest hemodynamic parameters were similar between the two groups.

Conclusions: IV infusion of ice cold saline is an efficacious method to achieve MTH in this swine model of cardiac arrest. Furthermore, IO infusion of cold saline is not sufficient to induce MTH in the time routinely available in the prehospital setting following OOHCA.

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Conflict of interest statement

Conflict of Interest: The authors report no conflicts of interest related to this manuscript.

Figures

Figure 1
Figure 1
Change in mean esophageal temperature over time by infusion route
See this image and copyright information in PMC

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