Q: How Therapeutic Hypothermia (TH) can be achieved by infusion of saline?


Answer: 

 Rapid intravenous bolus infusion of  Normal Saline (NS) with 30 mL/kg at 4°C (39°F), via pressure bag reduces the core temperature by more than 2°C per hour. Other "rule of thumb" method is to give a liter of cold saline (4°C 39°F) over 15 minutes. It drops the core temperature by approximately 1°C per hour. This method should be used with caution in patients with congestive heart failure (CHF) or renal insufficiency.


References:

1. Kim F, Olsufka M, Longstreth WT Jr, et al. Pilot randomized clinical trial of prehospital induction of mild hypothermia in out-of-hospital cardiac arrest patients with a rapid infusion of 4 degrees C normal saline. Circulation 2007; 115:3064. 

2. Kliegel A, Losert H, Sterz F, et al. Cold simple intravenous infusions preceding special endovascular cooling for faster induction of mild hypothermia after cardiac arrest--a feasibility study. Resuscitation 2005; 64:347.