Background: Therapeutic hypothermia has been recently approved to show benefits for neurological outcomes in patients after cardiac arrest. Application of both ECMO and surface cooling for treatment of therapeutic hypothermia has not yet been reported in the literature. We reported four cases that experienced in-hospital cardiac arrest during ECMO application treated with therapeutic hypothermia under surface cooling at Thammasat University Hospital.
Case Reports: Four cases of in-hospital cardiac arrest during ECMO application were treated with therapeutic hypothermia under surface cooling with similar machine. The characteristics of each patient were described. The core temperature control during treatment was reported with temperature curves. A Glasgow coma score was used as index for neurological outcome
Conclusion: Application of surface cooling together with extracorporeal membrane oxygenation (ECMO) is safe and
feasible. Both devices facilitate treatment with therapeutic hypothermia in patients with post-cardiac arrest.

Keywords: Therapeutic hypothermia, Cardiac arrest, Extracorporeal membrane oxygenation, Surface cooling