Targeted temperature management for adult out-of-hospital cardiac arrest: current concepts and clinical applications

Table 2 Cooling techniques

	Rapid infusion of ice-cold IV fluid and ice packs	Water-circulating blankets	Air-circulating blankets	Water-circulating gel-coated pads	Intravascular cooling devices
Induction phase
Simpleness
Pre-hospital	◯	×	×	×	×
After hospital arrival	◯	△	△	△	×
After hospital arrival	◯	Specialized devices	Specialized devices	Specialized devices	Specialized devices intravascular catheterization
Non-invasiveness	◯	◯	◯	◯	×
Non-invasiveness	◯	◯	◯	◯	intravascular catheterization
Cooling rate	×	◯	×	◯	◯
Cooling rate	0.32 ± 0.24 °C/h	1.33 ± 0.63 °C/h	0.18 ± 0.20 °C/h	1.04 ± 0.14 °C/h	1.46 ± 0.42 °C/h
Maintenance phase
Stability^a	×	×	×	×	◯
Stability^a	69.8 ± 37.6 %	50.5 ± 35.9 %	74.1 ± 40.5 %	44.2 ± 33.7 %	3.2 ± 4.8 %
Convenience	×	△	△	◯	◯
Convenience	Frequent manual exchange	Manual control	Manual control	Automated control	Automated control
Inexpensiveness	◯	△	△	×	×
Inexpensiveness	◯	Specialized devices	Specialized devices	Specialized devices	Specialized devices

^aThe percentage of time the patient’s temperature was out of range more than 0.2 °C below or above the target temperature
Reference: [49] Hoedemaekers CW, Ezzahti M, Gerritsen A, van der Hoeven JG. Comparison of cooling methods to induce and maintain normo- and hypothermia in intensive care unit patients: a prospective intervention study. Crit Care 2007; 11: R91

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