title: Postcardiac arrest temperature management: infectious risks.
abstract: OBJECTIVE
  Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery. Coupled with neurological benefit, multiple complications including infection have been associated with therapeutic hypothermia following out-of-hospital cardiac arrest. In this review, we will discuss therapeutic hypothermia, and more broadly, temperature management, as a risk for ICU infection.
  
  
  RESULTS
  The application of therapeutic hypothermia following out-of-hospital cardiac arrest has been associated with infectious complications. Studies of hypothermic animal models have provided useful insights into mechanisms by which therapeutic hypothermia confers neuroprotection. Ironically, the same mechanisms through which therapeutic hypothermia provides neuroprotection have been implicated in the risk of infection associated with therapeutic hypothermia. Studies have demonstrated types of infections, pathogens, and the impact of infections on mortality and neurological recovery.
  
  
  CONCLUSIONS
  Studies demonstrate increased rate of pneumonia and bacteremia but decreased rate of other infections, suggesting redistribution but no overall increased risk of infection per se. The diagnosis of infection during therapeutic hypothermia does not impact mortality or neurological recovery.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA.
authors.forename: Admire
authors.initials: A
authors.lastname: Kuchena
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Merkel
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hutchens
mesh_terms: D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D055499:Catheter-Related Infections / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D007362:Intensive Care Units; D018696:Neuroprotective Agents; D058687:Out-of-Hospital Cardiac Arrest / Q000276:immunology / Q000628:therapy*; D011014:Pneumonia / Q000276:immunology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D018696:Neuroprotective Agents