Why does therapeutic hypothermia work

Other concurrent supportive treatments may include an intra-aortic balloon pump, continuous renal replacement therapy, and prone patient positioning. Therapeutic hypothermia suppresses the inflammatory response, increasing the risk of infection. Ensure scrupulous hand hygiene and provide meticulous care to prevent hospital-acquired infections, such as catheter-associated bloodstream infections, ventilator-acquired pneumonia VAP , and catheter-associated urinary tract infections.

Hypothermia patients are vulnerable to aspiration and VAP because hypothermia impairs respiratory ciliary function and decreases gastric motility. To help prevent VAP, use such practices as appropriate oral care, suctioning, and head-of-bed elevation higher than 30 degrees. Vasoconstriction caused by hypothermia can lead to skin breakdown. To help prevent breakdown, use preventive measures, such as a low-airloss bed and waffle boots.

As described earlier, neurologic assessment presents challenges. The need for adequate sedation and neuromuscular blockade to control shivering—and hypothermia itself—can complicate standard neurologic assessment.

Our facility uses continuous EEG monitoring to help determine if the patient has any level of awareness. Be sure to provide family support and education. Cardiac arrest occurs suddenly and usually without warning.

To reduce their anxiety, explain the equipment, tests, monitoring, and procedures. They may express concern that their loved one is cold to the touch; teach them the reasons for therapeutic hypothermia and how long it will last. Reassure them that sedation and analgesia are being used to ease patient discomfort. Advise them that therapeutic hypothermia can improve outcomes after cardiac arrest.

Explain that the goal is for the patient to emerge from therapeutic hypothermia neurologically intact, without complications of critical illness. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. Centers for Disease Control and Prevention. Healthcare-associated infections.

Accessed May 11, Anesthesia and analgesia protocol during therapeutic hypothermia after cardiac arrest: a systematic review. Anesth Analg. Heier T, Caldwell JE. Impact of hypothermia on the response to neuromuscular blocking drugs. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest.

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Qadir R, Kanjwal K. Severe bradycardia with a prominent J wave refractory to atropine: was it a cause or a result of a fall? A case report and a brief review on the treatment of hypothermia. Am J Ther. Michelle E. Patricia R. Deckard has been aWebcast presenter for Medivance, Inc.

This article was peer-reviewed for bias and none was found. Ebright and the planners of this CNE activity have disclosed no relevant financial relationships with any commercial companies pertaining to this activity. It gives excellent Scientific as well as wonderful general information also.

It clears many doubts in our mind also. Supplement post. The article has a lot of good information. The patient survival rate in each study increased, and the improvement in neurological outcomes was significantly better than among patients in the group who maintained normal temperatures. As a result of this work and subsequent studies verifying these findings, the American Heart Association in and again in issued guidelines recommending cooling comatose survivors of cardiac arrest caused by certain irregular heart rhythms known as ventricular tachycardia VT and ventricular fibrillation VF.

Although therapeutic hypothermia will not work for every SCA patient treated, the good news is that this treatment offers more hope for improving brain function than in the past. Physicians believe, although the evidence is not strong, that the earlier the treatment is started the more effective it will be. The main risks of using hypothermia are infection and bleeding. If you know someone who has remained comatose after surviving SCA, he may be a candidate for therapeutic hypothermia.

Check with the physicians who are caring for the patient to see if the hospital is currently using this therapy and if your family member meets the criteria to be cooled. The therapy is not without risk and requires skilled implementation of techniques for managing the critically ill patients whose body temperatures have been lowered. Members of the critical care team must learn these techniques before using them clinically. Techniques can include ice packs, cooling mattresses, cooling blankets, catheters inserted into large blood vessels, and ice-cold IV saline.

A collaboration with PennSTAR offered the perfect solution: expert transport care at rapid transport times. The transfer process to HUP begins with a single call to a special hotline number. The ED staff in the originating hospital may have already begun the cooling process, with IV solutions and ice strategically placed around the patient ie, in the arm pits, the groin area, and around the head by the time PennSTAR arrives. This collaboration is what saved John Hunter. Despite excellent data that support use of therapeutic hypothermia, Abella said that fewer than one-third of US hospitals have it available.

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