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Chapter-08 Therapeutic Hypothermia

BOOK TITLE: Critical Care

Author
1. Shrikhande Pinak Ashok
ISBN
9789351522133
DOI
10.5005/jp/books/12670_9
Edition
1/e
Publishing Year
2016
Pages
5
Author Affiliations
1. Fortis Hospital, Vasant Kunj and Shalimar Bagh, New Delhi, India
Chapter keywords
Therapeutic hypothermia, cerebral blood flow, return of spontaneous circulation, CMRO2, intracranial pressure, hypothermia, mean arterial pressure

Abstract

Therapeutic hypothermia has shown to produce salutary chemical and histological effects in animal models of acute neuronal injuries. The only exception is treatment of patients with diffuse ischemic brain injury after cardiac arrest. Therapeutic hypothermia is applied to those adult cardiac arrest patients who have ROSC and are unresponsive after that. Induction, maintenance and rewarming are three phase of therapeutic hypothermia. The external cooling and internal cooling are two part of induction phase. In maintenance phase, hypothermia should be maintained for 12–24 hours from the time the target temperature was achieved. It is important to monitor patient’s comfort and need for sedation and/or muscle relaxant. Rewarming phase is very important to control temperature during rewarming; patient should be rewarmed slowly at the rate of 0.15°C–0.50°C to target temperature of 36°C over a period of 12 hours as there is a potential risk of rebound hyperthermia. Cardiovascular, infection, renal, gastrointestinal, metabolic and coagulopathy are the adverse effects of therapeutic hypothermia

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