What is the role of prehospital cooling in targeted temperature management (TTM)?

Updated: Jul 26, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Prehospital initiation of cooling was originally thought to potentially improve outcomes, as earlier provision would benefit patients. However, several trials have compared cold intravenous fluids to no cooling during transport. To date, no cooling maneuvers begun in the prehospital period have improved neurologic recovery or mortality. [1, 36, 72, 73, 74, 75]  One study suggested increased pulmonary edema and repeat cardiac arrest with 2 L of cold intravenous fluids. [75]

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