Cooling post-cardiac-arrest: Saving the Heart and Brain
The 2010 AHA Guidelines for resuscitation have a new emphasis on post-arrest patient care. A new hallmark practice is the emphasis on cooling arrest patients. As you know, hypothermia has been shown to preserve tissue and is commonly used in many types of surgical procedures. Therapeutic hypothermia in the post-arrest patient can help preserve both cardiac and brain function.
The AHA Guidelines emphasize the use of therapeutic hypothermia when indicated. Therapeutic hypothermia is defined as cooling the patient to 32-34 degrees centigrade (90-93 degrees Fahrenheit).
The evidence is stronger in children and infants, but studies in adults have shown improved neurologic function (long term) in patients treated with therapeutic hypothermia.
The guidelines state “Organized post–cardiac arrest care with an emphasis on multidisciplinary programs that focus on optimizing hemodynamic, neurologic, and metabolic function (including therapeutic hypothermia) may improve survival to hospital discharge among victims who achieve ROSC (return of spontaneous circulation) after cardiac arrest either in or out of hospital" (2010 AHA Guidelines for CPR and ECC).
Be prepared for therapeutic hypothermia in post-arrest patients, both adult and children. Continue to review the literature for further information on the benefits of therapeutic hypothermia.