Intravascular cooling devices circulating cold saline
or using metallic catheters provide rapid cooling rates
2.0–4.5°C/hour (CoolGard, SetPoint R), but at the
cost of an invasive procedure and risks of catheterrelated
complications.
Infusion of cooled fluids at 4°C can be used alone or
combined with other methods, and can provide cooling
rates of up to 3.5°C/hour. Peritoneal lavage and extracorporeal
circulation such as cardiopulmonary bypass
or femoro-femoral circulation have been used, but are
not practical in an intensive care unit (ICU) setting.
Helmet cooling devices have also been used (Bernard et
al, 2003; Polderman et al, 2005).