Therapeutic hypothermia induced during cardiopulmonary resuscitation using large-volume, ice-cold intravenous fluid

Resuscitation. 2008 Feb;76(2):311-3. doi: 10.1016/j.resuscitation.2007.07.017. Epub 2007 Aug 31.


Introduction: Therapeutic hypothermia after resuscitation improves outcome following prolonged out-of-hospital cardiac arrest. Laboratory studies suggest that this therapy may improve outcome further when induced during cardiopulmonary resuscitation. We report a case where therapeutic hypothermia was induced during cardiopulmonary resuscitation using large-volume (40 mL/kg), ice-cold (4 degrees C) intravenous fluid.

Design: Case report.

Setting: A tertiary level hospital in Victoria, Australia.

Case report: The patient suffered a cardiac arrest secondary to pericardial tamponade following right ventricular perforation during cardiac catheterisation. Percutaneous needle drainage was unsuccessful and open drainage via a left emergency thoracotomy was performed. Therapeutic hypothermia during cardiopulmonary resuscitation was induced using of a rapid infusion of large-volume (40 mL/kg), ice-cold (4 degrees C) crystalloid fluid. A spontaneous circulation was restored after 37 min of cardiac arrest. The patient made a satisfactory neurological recovery.

Conclusion: Treatment with a rapid intravenous infusion of large-volume (40 mL/kg), ice-cold (4 degrees C) fluid during cardiopulmonary resuscitation induces mild hypothermia and may provide neurological protection. Further clinical studies of this approach are warranted.

Publication types

  • Case Reports

MeSH terms

  • Body Temperature
  • Cardiac Tamponade / therapy
  • Cardiopulmonary Resuscitation / methods*
  • Emergency Medical Services
  • Female
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced / methods*
  • Infusions, Intravenous
  • Isotonic Solutions / administration & dosage*
  • Middle Aged
  • Temperature


  • Isotonic Solutions