Hypothermia Case Review

Initially, cooling was recommended to 32° C-34° C[6, 7], but the enhanced effect of cooling at 33° C compared to 36° C in terms of mortality and neurological outcome could not be proven[2]. Since the most optimal cooling level is yet unknown, current (2015) Resuscitation Guidelines recommend mild hypothermia treatment regimen at the temperature range between 32° C and 36° C[3, 4].

Purpose: The purpose of this speech is to educate and inform my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives.

Authors Meeusen and Lievens preform these test in order to help give positive feedback about the process of cryotherapy and they also allows them the chance to get background information on the health benefits as well. For people who prefer not to submerge in the water, the author provides alternatives such as freezing gel pack. This is important because some people cannot handle being submerged in ice water in order to get the full benefit of the process.

He then took samples of urine, blood, and mucous as body temperatures lowered. Through this tortured, Rascher used the data to create the hypothermia treatment called "active rapid rewarming." More than 90 people lost their lives for this medical advancement (Adams).

A Glasgow Coma Score of 8 or less also is an indication that the patient will need to be intubated soon. Once the tube is placed the ventilation may be useful in controlling the intracranial pressure as an intervention. Hyperventilation is a method used to reduce the carbon dioxide concentration in the vessels causing vasoconstriction which lessens the amount of blood circulating in the brain resulting in a decreased ICP (Zink and McQuillan, 2005). According to Zink and McQuillan, this intervention should only be utilized 24 hours after the initial injury because cerebral blood flow is often reduced at this point and constricting the vessels more may cause ischemia to occur. While using this technique it is important to monitor oxygenation to the brain tissue to assure no irreparable damage is

An aspect where fluid resuscitation can be beneficial to the outcome of the patient is when sepsis is present. According to Bozza et al (2010), “hemodynamic instability plays a major role in the pathogenesis of systemic inflammation, tissue hypoxia, and multiple organ dysfunction in sepsis,” and that fluid therapy reduces mortality in these patients by helping to restore this imbalance. Thus establishing that fluid resuscitation can be beneficial in prehospital care as it assists in maintaining adequate organ and tissue perfusion. This evidence is also supported by Daniels (2011), who outlines that early diagnosis and early fluid therapy is associated with decreased mortality in sepsis patients, as maintaining a systolic blood pressure

Original research related to sedation management occurred in the year 2000 by Kress, Pohlman, O ' Connor, and Hall. Their findings served as a landmark study and initiated the impetus related to improving our sedation practices. According to Kress et al. (2000), daily interruption of sedation led to a decrease in the number of days on the ventilator in the intensive care unit. Several studies since this time have focused on the influence of sedation protocols, and outcomes. This paper will review the synthesis of the discovered studies and highlight the noted contraindications and inconsistencies. Also, explanations including a preliminary conclusion will be discussed.

The safety and benefits of hypertonic saline resuscitation extend to both the pediatric and geriatric populations, but using solutions at the lower end of tonicity is probably safer. The greatest benefit may ultimately be for those patients with the most limited cardiopulmonary reserves, those with inhalation injury, and those with larger burns approaching 40% or

hypertension. Therapeutic hypothermia (THT) has been considered an effective method for reducing ischemic injury of the brain due to cardiac arrest. But there are some opponents in the medical community who believe that broadening the scope of THT could be dangerous to patients. Although opponents do not seem to blame THT for adverse patient outcomes; the disagreement seems to be about the variables involved before hospital arrival, amount of time that it takes to administer THT in the ER, which therapies should be administered with THT and the need for more research that tracks adverse events. A study published by The American Journal of Emergency Medicine supports the widely held view that THT is an effective treatment for cardiac arrest

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

Intraoperative hypothermia has been associated with various adverse effects and is said to be preceding increased in-hospital morbidity and length of stay:

One of the most significant mechanisms of severe preservation injury arises from ischemia of the organ resulting in an increase of antigen production. 1 This sets the precedence for the importance of critically analyzing injury recovery potential as propagated though normothermic preservation as opposed to cold static storage. Cold static storage lends itself heavily to injury as a result of oxygen deprivation prior to removal, cold storage ischemia, rewarming, and reperfusion in the recipient environment.2 Normothermic perfusion techniques effectively weave around the dangers of static cold storage through the constant perfusion of blood, oxygen, and nutrients, all while maintaining a sanguine environment for the excised liver. A 2011 study shows the drastic decrease of proinflammatory genes and cytokines, endothelial cell injury, and

Analysis of the data collected from the AFC and CFC groups yielded a few significant findings. Patients in the AFC group had a longer ICU length of stay than the CFC group, however hospital lengths of stay were similar. The AFC group was less likely to have a poor outcome 12 months after their SAH compared to the CFC group, however, this result was not consistent at the 14 day or 3 month mark. The authors suggest this may be the result of longer ICU stays and need for sedation to tolerate the AFC cooling modality. The only complications significantly different between the two groups were rates of hyperglycemia and arrhythmias: both were more likely to occur in the AFC group. While there was no difference in temperature between the groups on admission, there was significantly less fever burden on the AFC group during the first two weeks after SAH. The authors conclude that while AFC was associated with higher rates of hyperglycemia,

Due to cold conditions of spending nearly 30 hours at sea, Hypothermia was developed. The body was losing heat faster than it was gaining it and prolonged exposure to the cold conditions, led to the body temperature dropping below 35 degrees, lower than the healthy temperature of 37 degrees. In response, organs slow down, starting to fail. If temperature keeps decreasing organs will shut down leading to heart failure or death.

Rangel-Castillo et al. (2008) state that induced hypothermia can be used as an adjunctive treatment for increased ICP when other medical treatments are not fully effective. Induced hypothermia, 32-34 degrees Celsius, may provide some neuroprotective effect to TBI patients by reducing the cerebral metabolic rate of oxygen consumption. A single degree decrease in temperature will drop the brain oxygen consumption rate by 5-7%, thereby maintaining cerebral metabolism. However, there is not enough data currently available that supports the use and effectiveness of hypothermia in a head injury (Dinsmore, 2013). Mantilla & Arboleda (2015) cite that induced hypothermia fails to improve outcomes, and in fact leads to an increased morbidity. They suggest