Hypothermia

7 Pages 1866 Words

her in Europe) showed the

therapeutic value in survivors cardiac arrest. In the Australian study, which involved 77

patients who remained comatose after the restoration of spontaneous circulation, 49% of

those treated with hypothermia were discharged home or into a rehabilitation facility

compared to the 26% of those not treated with hypothermia. There were no significant

differences between the 2 groups with respect to the frequency of adverse events. The

out come of the European study, which involved 9 center in 5 countries and had a larger

number of patients, were similar. Taken together, the findings in these trials are important,

because in the United States so far, permanent brain damage after cardiopulmonary-

cerebral resuscitation causes many delayed deaths and is seen in about 10to 30 percent of

survivors of out-of hospital cardiac arrest. The fact that 2 studies yielded similar results

makes the important conclusions even more compelling. The rationale for the use of

therapeutic hypothermia is complex. Spontaneous uncontrolled hypothermia start with

potential deleterious shivering, thermo genesis , catecholamine release, and

vasoconstriction, there as controlled hypothermia is potentially beneficial. Therapeutic

hypothermia after cardiac arrest, as used in the 2 stories above, is directed at mitigating

neurological injury. Temperature levels are important; mild hypothermia (33°C to 36°C)

may be most effective, and is simple and safe. Moderate hypothermia (28°C to 32°C) can

cause arrhythmias or even ventricular fibrillation and if prolonged, can lead to

coagulopathy and infection. The timing and duration are important; mild hypothermia

should be initiated as soon as possible after resuscitation, but even when de...