Therapeutic hypothermia with esophageal heat transfer device

Purpose of the study: To evaluate the performance of esophageal heat transfer device (EHTD) in inducing, maintaining, and reversing therapeutic hypothermia in adult survivors of cardiac arrest. Materials and methods: We performed a prospective, interventional study from March to May 2015. EHTD (Esophageal Cooling Device, Advanced Cooling Therapy, Chicago, IL, USA) was inserted after admission and connected to chiller (CritiCool, MTRE, Rehovot, Israel). Study protocol was to achieve target temperature (32–34 ◦C in urinary bladder) within 1h after admission, maintain it until 24h after admission and rewarm to 36 ◦C at a rate 0.25–0.5 ◦C/h. Iced saline infusionduring induction (1000ml for initial temperature 34.1–35 ◦C and 20ml/kg if ≥35.1 ◦C) and external cooling/rewarming during maintenance and rewarming (for temperature outside the desired range for ≥2h) were allowed. Minor fluctuations were defined as