title: Hypothermia therapy: neurological and cardiac benefits.
abstract: Due to its protective effect on the brain and the myocardium, hypothermia therapy (HT) has been extensively studied in cardiac arrest patients with coma as well as in patients presenting with acute myocardial infarction (MI). In the setting of cardiac arrest, randomized studies have shown that HT decreases mortality and improves neurological outcomes. Subsequent guidelines have therefore recommended cooling (32°C to 34°C) for 12 to 24 h in unconscious adult patients with spontaneous circulation after out-of-hospital cardiac arrest due to ventricular fibrillation. Observational studies have also confirmed the feasibility of this therapy in clinical practice and support its early application in patients with nonventricular fibrillation cardiac arrest and in post-resuscitation circulatory shock. In patients with acute MI, available clinical evidence does not yet support HT as the standard of care, because no study to date has shown a clear net benefit in such a cohort. After a brief review of the mechanisms of action for HT, we provide a review of the clinical evidence, cooling techniques, and potential adverse effects associated with HT in the setting of post-cardiac arrest patient and acute MI.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USA.
authors.forename: Cédric
authors.initials: C
authors.lastname: Delhaye
authors.forename: Michael
authors.initials: M
authors.lastname: Mahmoudi
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000818:Animals; D006323:Heart Arrest / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D009422:Nervous System Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy