Eleven emergency departments and intensive care units participated in this multi-centre, single-arm descriptive study. Eighty-four patients after successful resuscitation from cardiac arrest were cooled with nasopharyngeal delivery of an evaporative coolant for 1 h. Subsequently, temperature was controlled with systemic cooling at 33 °C. Cooling rates, adverse events and neurologic outcome at hospital discharge using cerebral performance categories (CPC; CPC 1 = normal to CPC 5 = dead) were documented. Temperatures are presented as median and the range from the first to the third quartile.
Nasopharyngeal cooling for 1 h reduced tympanic temperature by median 2.3 (1.6; 3.0) °C, core temperature by 1.1 (0.7; 1.5) °C. Nasal discoloration occurred during the procedure in 10 (12 % ) patients, resolved in 9, and was persistent in 1 (1 % ). Epistaxis was observed in 2 (2 % ) patients. Periorbital gas emphysema occurred in 1 (1 % ) patient and resolved spontaneously. Thirty-four of 84 patients (40 % ) patients survived, 26/34 with favorable neurological outcome (CPC of 1–2) at discharge.
Nasopharyngeal evaporative cooling used for 1 h in primary cardiac arrest survivors is feasible and safe at flow rates of 40–50 L/min in a hospital setting.