Anest. intenziv. Med. 2012;23(3):138-146

Therapeutical hypothermia after cardiac arrestUpdate in Intensive Care Medicine

Škulec Roman

Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové

This review article of therapeutic hypothermia (TH) in cardiac arrest survivors is a transcription of the lecture presented at the Update In Intensive Care Medicine 2011 course by the Institute for Postgraduate Medical Education. In the light of current knowledge, the author describes the place of TH in complex post-cardiac arrest intensive care, analyzes answers to the questions "When to start cool?", "Whom to cool?", "For how long and how deep to cool?" and "How to cool?", assesses practical issues of delivering TH and presents a personal opinion on the current discussion whether TH should be used or not. TH in cardiac arrest patiens is an effective method to prevent posthypoxic encephalopathy. Cooling should be initiated as soon as possible. The target body temperature of 33 °C should be reached as fast as possible with further maintainance in the range of 32-34 °C for 12-24 hours. Rewarming should be controled to avoid rewarming rates higher than 0.5 °C/h. The procedure should be guided by a written protocol and performed in the setting of complex intensive care.

Keywords: cardiac arrest; therapeutic hypothermia

Received: April 30, 2012; Accepted: May 31, 2012; Published: June 1, 2012  Show citation