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KMID : 1144420180330040246
Acute and Critical Care
2018 Volume.33 No. 4 p.246 ~ p.251
Comparison between Gel Pad Cooling Device and Water Blanket during Target Temperature Management in Cardiac Arrest Patients
Jung Yoon-Sun

Kim Kyung-Su
Suh Gil-Joon
Cho Jun-Hwi
Abstract
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¡É) after initiation of cooling to evaluate the effectiveness of the cooling method. The temperature farthest from 33¡É was selected every hour during maintenance. Generalized estimation equation analysis was used to compare the absolute temperature differences from 33¡É during the maintenance period. If the selected temperature was not between 32¡É and 34¡É, 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¡É vs. WB, 35.6¡É; 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¡É during the maintenance period was 0.19¡É (95% confidence interval [CI], 0.17¡É to 0.21¡É) in the GP group and 0.76¡É (95% CI, 0.71¡É to 0.80¡É) in the WB group. GP significantly decreased this difference by 0.59¡É (95% CI, 0.44¡É to 0.75¡É; P<0.001).

Conclusions: The GP was superior to the WB for strict temperature control during TTM.
KEYWORD
body temperature, heart arrest, hypothermia, induced hypothermia
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