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Such long lasting functional neuroprotection has been reported despite up to 6 hours delay in initiating cooling in adult animal models [ 64- 66].
To compensate for the substantial ambient heat losses encountered in the laboratory, body temperature was stabilized prior to initiating cooling in the subsequent 2 swine.
Previous studies have demonstrated that most OHCA patients are relatively hypothermic in the prehospital phase, and whether initiating cooling, maintaining hypothermia or even normothermia would confer survival benefit remains unknown [ 5].
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The temperatures at which respondents initiate cooling, or warming, and the level of concern, is shown in table 1.
This method is generally recommended to initiate cooling in comatose survivors after CA, either alone or in conjunction with other cooling systems [53].
"The brain gets a signal that it's hot outside, [and] these sympathetic reflexes get elicited by that input to the brain to initiate cooling responses".
This method is generally recommended to initiate cooling in comatose survivors after CA, either alone or in conjunction with other cooling systems [ 53].
Site 2 initiated cooling at 20 minutes, and the ROSC rate for this site was 5/13 (39%) for RC compared with 7/13 (54%) in the controls.
Site 1 initiated cooling at 11 minutes, and the ROSC rate at this site was 3/6 (50%) for RC and 1/9 (11%) for controls.
Although therapeutic hypothermia has been widely implemented [ 5], its benefits are still questioned and several issues remain unanswered, including the optimal time to initiate cooling.
For many reasons – such as heterogeneity of the population studied, lack of information on the time required to recognize heatstroke and initiate cooling, and comparability of supportive management – how this favorable outcome compared with that of cooling by immersion in iced water is difficult to ascertain.
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