Comparison between gel pad cooling device and water blanket during target temperature management in cardiac arrest patients

초록

Background: Target temperature management (TTM) improves neurological outcomes for comatose survivors of out-of-hospital cardiac arrest. We compared the efficacy and safety of a gel pad cooling device (GP) and a water blanket (WB) during TTM. Methods: We performed a retrospective analysis in a single hospital, wherein we measured the time to target temperature (< 34°C) after initiation of cooling to evaluate the effectiveness of the cooling method. The temperature farthest from 33°C was selected every hour during maintenance. Generalized estimation equation analysis was used to compare the absolute temperature differences from 33°C during the maintenance period. If the selected temperature was not between 32°C and 34°C, the hour was considered a deviation from the target. We compared the deviation rates during hypothermia maintenance to evaluate the safety of the different methods. Results: A GP was used for 23 patients among of 53 patients, and a WB was used for the remaining. There was no difference in baseline temperature at the start of cooling between the two patient groups (GP, 35.7°C vs. WB, 35.6°C; P = 0.741). The time to target temperature (134.2 minutes vs. 233.4 minutes, P = 0.056) was shorter in the GP patient group. Deviation from maintenance temperature (2.0% vs. 23.7%, P < 0.001) occurred significantly more frequently in the WB group. The mean absolute temperature difference from 33°C during the maintenance period was 0.19°C (95% confidence interval [CI], 0.17°C to 0.21°C) in the GP group and 0.76°C (95% CI, 0.71°C to 0.80°C) in the WB group. GP significantly decreased this difference by 0.59°C (95% CI, 0.44°C to 0.75°C; P < 0.001). Conclusions: The GP was superior to the WB for strict temperature control during TTM. © © 2018 The Korean Society of Critical Care Medicine.

키워드