Hypothermia after cardiac arrest.
Mild therapeutic hypothermia (32 degrees C-34 degrees C) is the only therapy that improved neurological outcome after cardiac arrest in a randomized, controlled trial. Induced hypothermia after successful resuscitation leads to one additional patient with intact neurological outcome for every 6 patients treated. It protects the brain after ischemia by reduction of brain metabolism, attenuation of reactive oxygen species formation, inhibition of excitatory amino acid release, attenuation of the immune response during reperfusion, and inhibition of apoptosis. Potential side effects such as infections have to be kept in mind and treated accordingly. Mild hypothermia is a safe and effective therapy after cardiac arrest, even in hemodynamically compromised patients and in patients undergoing percutaneous coronary intervention. Its use is recommended by the American Heart Association and the International Liaison Committee on Resuscitation for unconscious adult patients with spontaneous circulation after out-of-hospital ventricular fibrillation cardiac arrest. Further research is needed to maximize its potential benefits.
Janata
Andreas
A
andreas.janata@meduniwien.ac.at
Holzer
Michael
M
D015906:Angioplasty, Balloon, Coronary; D001777:Blood Coagulation; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D016887:Cardiopulmonary Resuscitation; D006323:Heart Arrest / Q000150:complications / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D020925:Hypoxia-Ischemia, Brain / Q000517:prevention & control; D012768:Shivering / Q000502:physiology