Template:Therapeutic hypothermia overview
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- Therapeutic Hypothermia, define as deliberate cooling of a patient to 32-33.9°C (90-93F) who has no return of spontaneous neurologic activity after cardiac arrest. The goal is to reduce the repercussion injury to the brain which may be related to free radical formation, micro and macro circulation disruption and protease activation. At therapeutic temperatures the disruption of inflammatory and damaging cascades within the brain are thought to be decreased. [1]
- The HACA Trial (Hypothermia after Cardiac Arrest) randomized patients after witness Ventricular Fibrillation (VF) and pulseless Ventricular Tachycardia (VT) to 32-34°C Hypothermia. There was a significant patient centered outcome and 6 month mortality decrease in the hypothermia group. A later trial by Bernard et. al. demonstrated similar benefit and subsequent Cochrane reviews and the TTM Trial (33°C vs 33°C) found similar mortality and morbidity benefits.[1][2]
- Standard care established by the ACCF/AHA 2013 guidelines, recommend therapeutic hypothermia for any comatose patient with a STEMI and out of hospital cardiac arrest from VF or puleless VT[3]
- ↑ 1.0 1.1 Arrich J, Holzer M, Herkner H, Müllner M. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane Database of Systematic Reviews 2009. PMID
- ↑ Bernard SA et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557-63
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/23256913