Development of Therapeutic Hypothermia The importance of temperature management in the treatment of individuals afflicted by various medical ailments has been known for centuries with one of the earliest instances of this knowledge being recorded in the height of the Greek’s classical period. Hippocrates, a Greek physician commonly known as the father in medicine, was the first to describe the medical condition of hypothermia and note the importance of temperature in regards to some medical conditions. The following excerpt from Hippocrates writings demonstrates his rudimentary understanding of the correlation between temperature and medical conditions, “Old men have little warmth … for this reason, fevers are not so acute in old people for …show more content…
233). These experiments and others eventually led to the use of therapeutic hypothermia in humans undergoing certain cardiac surgery in which an extended ischemic period was expected although the degree of the therapeutic hypothermia, which ranged from 30-32 ºC, was associated with an increased risk of complications. As a result, the use of therapeutic hypothermia was relatively limited until it was discovered that by inducing a milder hypothermia (32-34 ºC) the number of complications associated with this protective treatment were greatly reduced. The publication of two landmark studies led to the widespread acceptance of mild therapeutic hypothermia as a protective measure for individuals who have experienced and out-of-hospital cardiac …show more content…
Shortly after the publication of these studies, the International Liaison Committee on Resuscitation, endorsed the use of therapeutic hypothermia stating that patients with a Glasgow coma scale of eight or less who regained spontaneous circulation after an out-of-hospital cardiac arrest and initially presented with ventricular fibrillation should be cooled to a core body temperature between 32 to 34 ºC and remain at that temperature for 12 to 24 hours (Nolan et al., 2003, p. 118-121). The American Heart Association soon followed suit and in 2010 proposed a nearly identical protocol, adding patients who first presented with ventricular tachycardia to the group of individuals who were eligible for this type of medical treatment (Peberdy et al., 2010, p.
The temperature decrease results in alterations of the autonomic sympathetic response[11] and in impaired conduction velocity of the electrical signals through the
Purpose: The purpose of this speech is to educate and inform my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives.
He then took samples of urine, blood, and mucous as body temperatures lowered. Through this tortured, Rascher used the data to create the hypothermia treatment called "active rapid rewarming." More than 90 people lost their lives for this medical advancement (Adams).
THT is the only therapy that has appeared to positively affect the neurological outcome of patients after cardiac arrest. THT has been around for more than fifty years. The history of the scope of THT is limited and the only consistent application of this therapy invasive surgery. Within the last 10 years, the benefits of induced therapeutic hypothermia have been rediscovered, mainly with the improvement in neurological outcomes in out-of-hospital cardiac arrest (OOHCA) victims. In addition, therapeutic hypothermia has been suggested to improve outcome in other neurological conditions such as traumatic brain injury, neonatal asphyxia, cerebrovascular accidents and intracranial
Markus Thalmann, the cardiac surgeon who saved the little girl from death by drowning in icy water, said that she was not the first hypothermia and suffocation case. However, she was the first one to survive. In her complicated rescue they tried to follow a checklist that stats that in such a case, a rescue team was required to tell the hospital to prepare for possible cardiac bypass and rewarming. So, what was so effective about this approach is that by the time the patient gets to the hospital, everything is ready and standing by. These kinds of cases are time sensitive. In such complicated cases, success requires having a huge number of equipment and people at the ready. So, even small simple checklist could help in complicated rescues and even bring people to life
The evidence surrounding the topic of therapeutic hypothermia post cardiac arrest is one lathered in potentially advantageous benefits, as well as harmful side effects. Although this procedure has potentially lifesaving and neurologically preserving implications, it does come with various side effects which can be dangerous in general or if left untreated. This paper will first address the many benefits, some of which include prolongation of life, retention of neurological function. It will then shed light upon some of the subsequent risks and harmful effects that are associated with therapeutic hypothermia. Lastly the paper will discuss why or why not the overall benefits outweigh the aggravating factors. Thus, being a topic of much controversy
The nursing topic that I am going to base my final paper on is the use of hypothermia therapy following the successful resuscitation of adult patients. I want to further understand the positive or the negative outcomes for patients after we have using the hypothermia therapy protocol. hypothermia _1_.pdf This is one of the research studies that I plan on using in the research for my finial paper. The PICO question that I will be trying to answer in my research paper will be " In the resuscitated adult patient does the use of hypothermia therapy have a reduced mortality rate for adult patients after they have been discharged from the hospital?" By using the definition of PICOT from our book, the P in my research is resuscitated adult patients,
Therapeutic hypothermia, also called targeted temperature management, is a procedure that lowers the body's temperature in order to treat a heart that has suddenly stopped working (cardiac arrest). This procedure is used in emergency situations. During cardiac arrest, the brain cannot get enough oxygen. The brain also starts to swell, which can damage or kill brain cells. Therapeutic hypothermia helps reduce swelling in the brain. It also slows down the body's metabolism and allows the heart and brain to recover.
Malignant hypothermia is a disease, caused by a bad reaction of anesthetics. This disease causes an immensely rapid temperature rise and extreme muscle contractions. MH (malignant hypothermia) is passed down through families and inherited by one parent carrying it giving it to the child. “Malignant hyperthermia occurs in 1 in 5,000 to 50,000 instances in which people are given anesthetic gases” (NIH, 2007). Most people aren’t aware that they are prone to this disease/reaction because they have never been under anesthesia drugs, or have never received surgery.
He advocated that wounded soldiers be packed in snow and ice to improve outcomes following injury. Despite ancient beginnings, it was not until the early 1990s that researchers began to study the effects of TH in laboratory animals. In 1991 Sterz and colleagues (as cited in Lee & Asare, 2010), “demonstrated in a dog model that hypothermia induced after cardiac arrest was associated with significant improvements in neurologic outcomes” (p. 1229). In 2002, these early animal studies were supplemented by two simultaneously published landmark human studies. Both human studies were controlled and randomized. One of the studies took place in Europe and the other was conducted in Australia.
Andrzejowski, J.; Hyle, J.; Eapen, G.; Turnbull, D. (2008), refers to review of literature of previous publications, such as the study by Vanni and colleagues. This study showed an notable effect of prewarming, but was flawed both by inadequate power (10 patients per group) and by having a control group that was significantly hypothermic before anesthetic induction. Two additional studies also showed a smaller decrease in core temperature during surgery after a period of prewarming, but neither study warmed patients intraoperatively A large randomized trial of prewarming, by Melling and colleagues involved more than 400 patients. Their study looked for differences in postoperative complications and showed a significant decrease in
Hypothermia is not a widely used treatment due to risk for complications associated with hypothermia such as pneumonia, seizures and infection.
Hypothermia has two main types of causes. It classically occurs from exposure to extreme cold. Commonly this includes alcohol intoxication but may also include low blood sugar, anorexia, and advanced age. Hypothermia may be diagnosed based on either a person's symptoms in the presence of risk factors or by measuring a person's core temperature. One of the lowest documented body temperatures from which someone with accidental hypothermia has survived is in a near-drowning of a 7-year-old girl in Sweden. Survival after more than six hours of CPR has been described. Symptoms of mild hypothermia may be vague, Increased urine production due to cold, mental confusion, and hepatic dysfunction may also be present. Hyperglycemia may be present, as glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity to insulin may be blunted. Sympathetic activation also releases glucose from the liver. In many cases, however, especially in alcoholic patients, hypoglycemia appears to be a more common presentation. Low body temperature results in shivering becoming more violent. Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the person may appear alert. Surface blood
David Casarett, there are many ways to preserve life after cardiac arrest. He says that all this research has led to most things used today that keep us alive longer. One of these things were Researchers at the University of Pittsburgh’s Safar Center chilling dogs at a very low temperature that helped keep them alive after cardiac arrest. He states that these studies have led to clinical trials that are designed to save patients who wouldn’t survive with conventional treatment.
Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies.