Therapeutic Hypothermia: Comparing Surface vs Intravascular Cooling

Therapeutic hypothermia (TH) has shown promise for increasing survival and neurological recovery for post-cardiac arrest patients who are not responding neurologically initially after return of spontaneous circulation.

The aim of this study was to explore the differences between surface and intravascular cooling methods of TH related to survival and neurological outcomes in post-cardiac arrest patients.

A literature search was conducted from 2008 to 2018 using 4 databases, including PubMed, CINAHL, Web of Science, and Scopus.

Six articles were identified that compared surface and intravascular cooling for TH in post-cardiac arrest patients, with the outcomes being mortality and neurological outcome. The articles included observational retrospective studies, a systematic analysis, and randomized controlled studies. The articles had between 167 and 934 participants from multiple locations, including Europe, Australia, France, Norway, the Netherlands, and South Korea. The analyzed literature did not highlight differences in mortality or neurological outcome when surface cooling or intravascular cooling was used in post-cardiac arrest patients. One study did find that intravascular cooling was superior to surface cooling in mortality and neurological outcome. Three studies showed better survival rates after intravascular cooling even if not statistically significant. Clinically, using either cooling method is acceptable.

This review found no difference between intravascular and surface cooling and effects on survival and neurological outcome. More research needs to be performed on the best type of cooling method as well as the best product within each category.