Presentation (CTI)

OBJECTIVES: Active temperature management at subnormal temperatures has been an important, evidence-based component of adult post-cardiac arrest care for two decades. Cooling may be achieved via different techniques including surface cooling. Of these systems, conventional water-circulating cooling blankets (CCB) may be ineffective as a means of conductive heat transfer because they make poor surface contact with the skin. Recently, new external cooling devices have been developed that employ self-adhesive, hydrogel-coated pads that circulate temperature-controlled water under negative pressure. These advanced targeted temperature management (ATTM) devices have been found to be associated with lower fever burden, greater time at target temperature, and lower incidence of thrombocytopenia in neonates. This analysis examines the potential economic impact that could result from a reduction in time-to-target-temperature.
METHODS: A systematic review of original research published 2003 through 2025 (PubMed) assessed time-to-target-temperature for different surface cooling devices. The results were analyzed and applied to a model to estimate potential cost avoidance if reduction in time-to-target-temperature also reduced length of stay (LOS) in the intensive care unit (ICU).
RESULTS: 20 records were identified. After exclusions, 16 records were reviewed, and 3 were analyzed. The mean reduction in in time-to-target-temperature with ATTM systems compared to CCB systems was found to be 5.11 hours. Assuming this time reduction resulted in an equivalent reduction in ICU LOS, at a mean cost per ICU day of $8,823, the mean cost avoidance with use of a ATTM system would be $1,880.
CONCLUSIONS: ATTM systems may avoid substantial ICU costs compared to CCB systems if reductions in time-to-target-temperature result in equivalent reductions in ICU LOS.