Therapeutic hypothermia after cardiac arrest: Unintentional overcooling is common using ice packs and conventional cooling blankets

Raina M. Merchant*, Benjamin S. Abella, Mary Ann Peberdy, Jasmeet Soar, Marcus E.H. Ong, Gregory A. Schmidt, Lance B. Becker, Terry L. Vanden Hoek

*Corresponding author for this work

    Research output: Contribution to journalArticle (Academic Journal)peer-review

    154 Citations (Scopus)


    OBJECTIVES: Although therapeutic hypothermia for cardiac arrest survivors has been shown to improve neurologically intact survival, optimal methods to ensure controlled induction and maintenance of cooling are not clearly established. Precise temperature control is important to evaluate because unintentional overcooling below the consensus target range of 32-34°C may place the patient at risk for serious complications. We sought to measure the prevalence of overcooling (<32°C) in postarrest survivors receiving primarily noninvasive cooling. DESIGN: Retrospective chart review of postarrest patients. SETTING: Three large teaching hospitals. PATIENTS: Cardiac arrest survivors receiving therapeutic hypothermia. INTERVENTIONS: Charts were reviewed if primarily surface cooling was used with a target temperature goal between 32°C and 34°C. MEASUREMENTS AND MAIN RESULTS: Of the 32 cases reviewed, overcooling lasting for >1 hr was identified as follows: 20 of 32 patients (63%) reached temperatures of <32°C, 9 of 32 (28%) reached temperatures of <31°C, and 4 of 32 (13%) reached temperatures of <30°C. Of those with overcooling of <32°C, 6 of 20 (30%) survived to hospital discharge, whereas of those without overcooling, 7 of 12 (58%) survived to hospital discharge (p = not significant). CONCLUSIONS: The majority of the cases reviewed demonstrated unintentional overcooling below target temperature. Improved mechanisms for temperature control are required to prevent potentially deleterious complications of more profound hypothermia.

    Original languageEnglish
    Pages (from-to)S490-S494
    JournalCritical Care Medicine
    Issue number12 SUPPL.
    Publication statusPublished - Dec 2006

    Bibliographical note

    Copyright 2013 Elsevier B.V., All rights reserved.


    • Body temperature regulation
    • Cardiac arrest
    • Hypothermia
    • Resuscitation
    • Sudden cardiac death


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