Other than using an endovascular cooling device, what are the most effective mechanisms for inducing hypothermia after cardiac arrest?

A Karen McQuillan, RN, MS, CCRN, CNRN, replies:

Evidence-based recommendations from the International Liaison Committee on Resuscitation (ILCOR), also incorporated into the guidelines of the American Heart Association (AHA), advocate use of 12 to 24 hours of mild hypothermia (32°C [89.6°F]-34°C [93.2°F]) for adults experiencing out-of-hospital cardiac arrest with an initial rhythm of ventricular fibrillation who have return of spontaneous circulation but remain unconscious on admission.1,2 This recommendation is based primarily on findings from 2 randomized controlled trials that compared maintaining normothermia versus cooling to 32°C to 34°C for 12 to 24 hours within hours to minutes after return of spontaneous circulation in adults who had regained hemodynamic stability but remained comatose after out-of-hospital ventricular fibrillation cardiac arrest. Study results indicated that use of mild hypothermia reduced mortality...

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