The effect of therapeutic hypothermia after cardiac arrest

Neurological impairment is common in survivors after cardiac arrest. Mild therapeutic hypothermia (32-34°C) has been suggested to be useful in improving both survival rates and neurological outcome of these patients. Aim: The aim of the present study was to explore the relation between the method of mild therapeutic hypothermia, in ICU, with the traditional method (normothermia), for the treatment of out-of-hospital cardiac arrest survivals, after restoring spontaneous circulation. Material and method: As for the design, it was a retrospective study. The studied population consisted of 25 patients who suffered cardiac arrest, with initial cardiac rhythm ventricular fibrillation (VF) or ventricular tachycardia (VT),who were successfully resuscitated and hospitalized after restoration of spontaneous circulation. During a 2-year period (2009-2011) these patients were treated with hypothermia (32-34°C) with ice packs or an endovascular cooling device. Results: he systematic cooling of survivals, between 32-34°C for a 24-hour period, increased the probability of survival (p=0.17) and improved neurological outcomes (p= 0.06), compared to normothermia. Complications, such as arrhythmias, bleeding and infections were treated by rewarming. Conclusions: Although there is a number of complications associated with hypothermia such as arrhythmias, bleeding disorders and infection, none seems to relate to adverse patient outcomes.

Keywords: Spontaneous circulation, neuro-protection, cooling, mild therapeutic hypothermia, ICU