Head and neck cooling after cardiac arrest results in lower jugular bulb than esophageal temperature☆
Received 22 January 2008; received in revised form 26 March 2008; accepted 27 March 2008.
Abstract
Purpose
To determine whether during the initial phase of head and neck cooling, jugular bulb temperature (Tjb; which may reflect brain temperature) is lower than esophageal temperature (Tes).
Basic Procedures
To compare Tes and Tjb, patients received head or head and neck cooling after cardiac arrest.
Main Findings
The first series with head cooling (n = 5; mean age 54 with a range of 41-62 years; 1 female and 4 males; mean body weight 80 kg with a range of 70-85 kg) showed a mean difference of 0.22°C (95% CI, −1.14 to 0.70; P = .55; limits of agreement, −3.17 to 2.73) between Tes and Tjb over 12 hours. For the second series, with head and neck cooling (n = 6, mean age 65 with a range of 56-76 years; 3 females and 3 males; mean body weight 75 kg with a range of 65-91 kg), Tjb was lower than Tes with a difference of 0.60°C (95% CI, 0.22 to 0.99; P = .01; limits of agreement, −3.10 to 4.30). During the first 3 hours, Tjb decreased faster than Tes (1.1°C/h [95% CI, 0.4 to 1.8; P < .01]).
Principal Conclusion
During the initial phase of therapeutic hypothermia, Tjb seems to be lower than Tes.
Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
Corresponding author. Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, 1090 Wien, Währinger Gürtel 18-20 (6/D), Austria. Tel.: +431404001964; fax: +431404001965.
☆ Conflict of interest: Cosima Wandaller was employed at the Department of Emergency Medicine, Medical University of Vienna with support of a grant from Medizinisch-Wissenschaftlicher Fonds des Bürgermeisters der Bundeshauptstadt Wien (Medical-Scientific Fund of the Mayor of Vienna, Austria) and MedCool, Inc, which provided technical support and the RapidCool system. The study sponsors had no involvement in the study design, in the collection, analysis, and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.
ABSTRACT