Usefulness of a surface cooling device (Arctic Sun®) for therapeutic hypothermia following cardiac arrest

Aims: Cardio-pulmonary resuscitation and therapeutic hypothermia (TH) have improved the neurological outcomes of patients who have suffered sudden cardiac arrest; however, the benefits of and differences between cooling devices remain unclear. The aim of this study was to clarify the significance of the Arctic Sun (R) for surface cooling in patients treated with TH. Methods: Fifty-one patients (60.2 +/- 14.2 years, 42 males and 9 females) who experienced cardiogenic cardiac arrest, including both shockable and non-shockable cardiac arrest, were enrolled in this study. Forty patients were treated with TH using the Arctic Sun 2000 (R) for surface cooling, while the other 11 patients were treated with TH using conventional standard cooling blankets. The patients' clinical courses during TH and the neurological outcomes were compared between the two groups. Results: The body temperature before TH was not significantly different between the two groups; however, the minimal body temperature during TH was significantly lower in the patients cooled with conventional standard blankets than in those cooled using the Arctic Sun 2000 (R). The rates of catecholamine administration, left ventricular ejection fraction, and mechanical support were not significantly different between the two groups; however, the maximum infusion dose of dobutamine was significantly lower in the patients with the Arctic Sun 2000 (R) than in those treated with standard cooling blankets. Conclusions: The use of TH with the Arctic Sun 2000 (R) following cardiac arrest is safe and effective in precisely maintaining the target body temperature, and can be used to reduce the infusion dose of dobutamine to treat heart failure during TH. (C) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.