Cardiac Arrest Clinical Trial
Official title:
Temperature Control With an Esophageal Cooling Device: A Feasibility Study in Post Cardiac Arrest Patients
This is a prospective, interventional study aiming to assess the effectiveness of the Esophageal Cooling Device (ECD) as a temperature control modality in post cardiac arrest patients. In addition, observed adverse events during ECD use, ease-of-use, nurse satisfaction and patient outcomes will be examined.
Temperature control in comatose survivors of cardiac arrest, is a critical aspect of these
patients' care. In this context, mild temperature reduction for 24 hours post cardiac arrest
has been shown to improve neurological outcomes.
Hypothermia is commonly induced using a combination of internal and external cooling
modalities. Internal cooling modalities include intravenous administration of cold
crystalloids and intravascular cooling catheters. External or body surface cooling can be
achieved using cooling blankets, adhesive pads, and ice packs. Each of these methods however,
has its limitations.
Administration of intravenous refrigerated crystalloid (4°C) boluses is a simple, effective
and widely available method of hypothermia induction. Lack of precise temperature control and
the potential for pulmonary edema however, make this modality unsuitable for the maintenance
phase of hypothermia. Surface cooling methods, such as cooling blankets and ice packs, often
cause shivering, skin breakdown, and in obese patients may be ineffective. Intravascular
cooling catheters require the time of a physician for insertion and bear the potential risks
of line infection and deep venous thrombosis. Searching for a temperature control device that
overcomes the limitations, inefficiencies and inconveniences of existing modalities is
therefore strongly desired.
The ideal temperature control modality should be effective, predictable and easy to use. An
esophageal cooling device has recently become available which in theory may, may possess some
of these attributes. To date, there have been no published studies examining this device's
efficacy. In addition, no study has documented any adverse events during it's use, or
evaluated it's ease-of-use at the bedside.
This is a prospective, interventional study aiming to assess the effectiveness of the
Esophageal Cooling Device (ECD) as a temperature control modality in comatose survivors of
cardiac arrest (the E-Chill trial). In addition, observed adverse events during ECD use,
ease-of-use, nurse satisfaction and patient outcomes will be examined.
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