Therapeutic Hypothermia: Preventing Damage After Cardiac Arrest

Initially, cooling was recommended to 32° C-34° C[6, 7], but the enhanced effect of cooling at 33° C compared to 36° C in terms of mortality and neurological outcome could not be proven[2]. Since the most optimal cooling level is yet unknown, current (2015) Resuscitation Guidelines recommend mild hypothermia treatment regimen at the temperature range between 32° C and 36° C[3, 4].

❑ To maintain cerebral blood flow (CBF), it is necessary to keep cerebral perfusion pressure (CPP) in the range of 60 – 100 mm Hg. When auto regulation is impair red, the CBF fluctuates with changes in the systemic blood pressure. This may be seen in the patient that is suctioned or who coughs, which causes a rise in blood pressure, resulting in elevated ICP. MAP that is greater than 60 mmHg is enough to sustain the organs of the average person. MAP is normally between 70 to 110 mmHg. If the falls below this number for an appreciable time, vital organs will not get enough Oxygen perfusion, and will become ischemic. A CPP less than 50 mmhg is

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).

It is a beneficial treatment that should be implemented as early in patient care as possible, such as, within the EMS system. Through the last century this therapy has been accepted and rejected by many medical professionals. Since medicine is an ever-changing field, future research and practice of hypothermia will dictate if this therapy is more beneficial than harmful, and maybe one day could be a permanent major role, or it may never be used again. Hypothermia has been proved to decrease neurological impairment after cardiac arrest, but also has many limitations that can occur. A major limitation of this therapy is, if continued care cannot be guaranteed by receiving hospitals, therapeutic hypothermia is irrelevant for EMS to initiate. Likewise, if hypothermia is not begun in the field by EMS, then the receiving facilities now will have a delayed time in starting the therapy and anoxic brain injury could have already occurred. EMS agencies can drive the implementation of therapeutic hypothermia in the medical field. This therapy allows EMS providers to have a major role in the outcome of a cardiac arrest patient’s recovery and neurological outcome. With the progression of research and practice, medicine is evolving day after day, and patient mortality and morbidity have decreased over the years. Although, cardiac arrest patients have a poor

hypertension. Therapeutic hypothermia (THT) has been considered an effective method for reducing ischemic injury of the brain due to cardiac arrest. But there are some opponents in the medical community who believe that broadening the scope of THT could be dangerous to patients. Although opponents do not seem to blame THT for adverse patient outcomes; the disagreement seems to be about the variables involved before hospital arrival, amount of time that it takes to administer THT in the ER, which therapies should be administered with THT and the need for more research that tracks adverse events. A study published by The American Journal of Emergency Medicine supports the widely held view that THT is an effective treatment for cardiac arrest

The lack or delay in appropriate treatment for individuals who experience a sudden cardiac arrest has created a major public health disparity. Research into pre-hospital treatment and subsequent implementation has historically seen neglect by the medical and scientific community creating vast differences in survivability of cardiac arrests between demographic groups. In 2010, the American Heart Association and Emergency Cardiovascular Care program developed the 2020 impact goal to reduce death from cardiovascular disease and stroke by 20% and double out-of-hospital cardiac arrest (OHCA) survival rates (http://circ.ahajournals.org/content/121/4/586#sec-1). This has prompted a massive influx of research into the disparities that exist and an

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

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

Patient complained of being cold due to constriction of vessels and decreased blood supply. Therefore, Keep the patient warm in order to help dilate vessels and bring more blood supply with it.

Early hemodynamic assessment on the basis of physical findings, vital signs, central venous pressure, and urinary output fails to detect persistent global tissue hypoxia. A more definitive resuscitation strategy involves goal-oriented manipulation of cardiac preload, afterload, and contractility to achieve a balance between systemic oxygen delivery and oxygen demand. End points used to confirm the achievement of such a balance (hereafter called resuscitation end points) include normalized values for mixed venous oxygen saturation, arterial lactate concentration, base deficit, and pH. Mixed venous oxygen saturation has been shown to be a surrogate for the cardiac index as a target for hemodynamic therapy. In cases in which the insertion of a pulmonary-artery catheter is impractical, venous oxygen saturation can be measured in the central circulation (p. 1368).

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.

The implementation of advanced emergency management (drugs, endotracheal intubation) and post-cardiac arrest care (therapeutic hypothermia, coronary intervention) was also investigated. A total of 4,156

His last article on the value of lowering body temperature to preserve cerebral function in patients after resuscitation from cardiac arrest was published a month before he died [ (Bryan-Brown, 2004) ]

Aside from these benefits, cryotherapy is also known to carry a few side effects that are not so dangerous such as scarring and mild skin irritation. The only major concern is that the nearby areas of the skin that are healthy may become