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Therapeutic Hypothermia After Cardiac Arrest

Introduction

Therapeutic hypothermia is widely used to enhance the survival of patients. This technique is used to protect the brain after successful resuscitation. Health care specialists perform body hypothermia up to 32-34° C using a cooling catheter that is typically administered into the femoral vein. In addition, external cooling can be performed with the help of a special blanket, a jacket for the upper part of the body, or applicators that are placed on the patient’s feet (Pearson & Heffner, 2013). The cooling is carried out through the circulation of water within the blanket or applicators. The researchers argue that this method can improve the survival rate of patients compared to the cases when they did not receive such care.

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Key Points

The article by Pearson and Heffner (2013) revealed that:

  • This procedure is the only method that displayed a positive effect on the neurological recovery of patients.
  • Therapeutic hypothermia should be considered for application to each patient who is unable to follow the verbal commands; however, only after the spontaneous circulation was returned.
  • To ensure that positive results will be achieved, patients in an unconscious state after cardiac arrest (due to ventricular fibrillation) and after they have restored the blood circulation, must be exposed to cooling measures of 32-34° C during the next 12-24 hours maximum.
  • In general, the patients who were exposed to cooling measures showed a decrease in metabolism, normalization of cerebral hemodynamics, blockade of neuroinflammation, the apoptosis was prevented, neurotransmitter levels were normalized, and indicators of the blood-brain barrier permeability were decreased (Pearson & Heffner, 2013).
  • If the cooling is started after 1.5 hours after the blood circulation was returned, the number of the dead nerve cells could be reduced by 70%; if the measures are started up to 5.5 hours, the number of the dead nerve cells will be reduced by 50% approximately. If the cooling is started after 8 hours, it can no longer be considered statistically significant.

Summary and Relation to the Topic

According to the article, the positive outcomes of the cooling measures have been revealed in one patient out of every six survivors. Despite the possible consequences to the health status, “the Hypothermia After Cardiac Arrest (HACA) study defined a Cerebral Performance Category (CPC) score of 1 (patient is alert with normal cerebral function) or 2 (patient is alert and has sufficient cerebral function to live independently and work part-time) as a good neurological outcome” (Pearson & Heffner, 2013, p. 2).

Consequently, the use of therapeutic cooling measures evidences better outcomes and survival rates. Most importantly, the research results stressed out that patients should be provided with the measures notwithstanding their arrest rhythm since the analysis revealed a positive tendency of neurological recovery (Pearson & Heffner, 2013). Thus, the controlled induced decrease in core temperature is an effective method to reduce the risk of ischemic damage to the brain tissue after a period of circulatory disorders.

Conclusion

Based on the research article results, it can be argued that hypothermia has a pronounced neuroprotective effect. At present, this therapeutic method is regarded as the basic technique for the physical neuroprotective cerebral defense. Until present, from the standpoint of evidence-based medicine, there are no pharmacological means of neuroprotection; thus, this method should be used to achieve better patient outcomes and higher survival rates.

Reference

Pearson, D., & Heffner, A. (2013). Practical aspects of postcardiac arrest therapeutic hypothermia. EMCC, 3(3), 1-20.

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StudyCorgi. 2020. "Therapeutic Hypothermia After Cardiac Arrest." December 2, 2020. https://studycorgi.com/therapeutic-hypothermia-after-cardiac-arrest/.

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StudyCorgi. (2020) 'Therapeutic Hypothermia After Cardiac Arrest'. 2 December.

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