Presentation (CTI)

OBJECTIVES: Intravascular temperature management (ITM) is used for temperature control in stroke, cardiac arrest, and traumatic brain injury patients. While ITM systems have been found to have faster time-to-target-temperature compared to other advanced targeted temperature management systems, they have also been associated with infectious and non-infectious complications. While the rates of thrombolytic complications are high (up to 90%), the incidence of major adverse events (AEs) is less acute. This analysis examines the frequency of major AEs and their contribution to the cost of care for patients undergoing ITM.
METHODS: A systematic review of original research published 2010 through 2025 (PubMed) assessed targeted temperature management/therapeutic hypothermia studies involving ITM which also reported major AEs including deep vein thrombosis (DVT) and pulmonary embolism (PE). The incidences of those complications were multiplied by the range of costs for those hospital-onset AEs to arrive at an incremental per-case cost.
RESULTS: 6 records were identified. After exclusions, 4 were analyzed. When reported, the rates of DVT associated with ITM were found to range from 0.4% to 4.9% of cases and PE from 0.2% to 9.1% of cases. Those values were applied to the cost of hospital-onset DVT and PE reported by the Agency for Healthcare Research and Quality. After adjusting for inflation, the per case cost of these major AEs ranged from $59 to $90 for the study with the lowest frequency of major AEs (0.5%) to $1,153 to $2,015 for the study with the highest frequency of major AEs (9.1%).
CONCLUSIONS: Organizations may wish to be attentive to the risk of major AEs and their attendant costs as they consider ITM for temperature control in critically ill patients. When the costs of AEs are considered, use of ITM devices may contribute as little as $59 but as much as $2,015 to the cost of patient care.