Seng Eap, BSN, RN, CCRN

Therapeutic Hypothermia Management

Tags: cardiac cerebral ischemia critical care hemorrhage Hypothermia perioperative recommendations Subarachnoid Hemorrhage Therapeutic Hypothermia therapy traumatic brain injury treatment

The leading cause of death in North America is heart disease, resulting in 611,105 deaths in the last year. Cardiac arrest accounts for more than 300,000 heart disease related deaths. Patients that receive early quality chest compressions and defibrillation present with increased survival rate, however, the degree of brain dysfunction varies. The advancement in cardiopulmonary resuscitation after cardiac arrest and the use of therapeutic hypothermia have minimized brain injury and improved neurologic outcome. In 2002, two studies demonstrated the use of therapeutic hypothermia after cardiac arrest proving to lower mortality rate and have neuroprotective effect. This led the American Heart Association and the International Liaison Committee on Resuscitation to recommend the implementation of therapeutic hypothermia after the return of spontaneous circulation post-cardiac arrest. Mild hypothermia is also utilized in traumatic brain injury to control cerebral edema and to decrease intracranial pressure (ICP), cerebral ischemia, and subarachnoid hemorrhage (SAH). However, clinical effectiveness for subarachnoid hemorrhage is still questionable. This paper will focus on the recommendations for therapeutic hypothermia after cardiac arrest as well as a briefly discuss its use for clinical trials in traumatic brain injury, cerebral ischemia, and SAH.