[Induced mild hypothermia to limit neurological damage after resuscitation].
Despite improvements in resuscitation techniques, the prognosis for patients who experience cardiac arrest outside of a hospital remains relatively poor. This is mainly due to brain damage that occurs as a result of global cerebral ischaemia. In 2002, two prospective randomised multicentre studies demonstrated that induced mild hypothermia can increase the chance of good neurologic recovery after out-of-hospital cardiac arrest by at least 40%. For this reason, induced mild hypothermia (32-34 degrees C) was included in the resuscitation guidelines developed by the International Liaison Committee on Resuscitation. Mild hypothermia is relatively easy to apply and has few complications. Compared with normothermia, induced mild hypothermia increases the chance of good neurological recovery by 1.7-fold. A safe and effective method to induce mild hypothermia is the infusion of cold fluids during sedation and mechanical ventilation. Cardiac function, renal function and electrolytes must be monitored closely during induced mild hypothermia. Given the potentially deleterious effects of rapid rewarming, a maximal rewarming rate of 0.5 degrees C per hour is recommended.
de Pont
A C J M
AC
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Intensive Care Volwassenen, C3-327, Meibergdreef 9, 1105 AZ Amsterdam. a.c.depont@amc.uva.nl
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003422:Critical Care; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome