Therapeutic Hypothermia Summary

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In this article published in the journal Dyanmics, also known as the journal for the Canadian Association of Critical Care Nurses, the authors review a retrospective cohort regarding the barriers for time to target temperature management in cardiac arrest patients who are treated with therapeutic hypothermia. The article authored by a both registerd nurses and medical doctors open by reviewing the benefits of therapeutic hypothermia. The article reviews two randomized controlled trials that showed that therapeutic hypothermia when compared to no intervention correlated with improved neurological survival in patients after cardiac arrest. Therapeutic hypothermia has a direct relation to patient survival with intact neurologic function; however…show more content…
This retrospective review showed that the greatest barrier to TTT was that physicians chose to start therapeutic hypothermia upon admission to the ICU versus in the field or in the emergency room. The study concluded that only 18% of the time the hospital was able to get patients to target temperature (with the mean TTT of 461 minutes) despite a protocol being in place. This barrier was typically due to the decision to cool the patient being made in the ICU, hours after return of spontanous circulation (ROSC) in the emergency room. The importance of this article shows that time is a sensitive component to the succes of therapeutic hypothermia for patients after an out of hospital cardiac arrest. There not only need to be protocols regarding therapeutic hypothermia, but also initiatives to start cooling the patient as soon as possible after…show more content…
This article is a example of a foundation of knowledge on the topic of therapeutic hypothermia. Gardner & MacDonald discuss that the typical post cardiac arrest patient does not survive or will recover with severe neurologic deficits as a result of ischemic brain injury from lack of blood flow to the brain (2013). The process of brain death is examined as well as the damange that occurs with reperfusion after ROSC. Damage particularly to the cerebral cortex, cerebellum and hypothalamus can leave the patient in a comatose state if revived (Gardner & MacDonald, 2013). This article is particuarlly valuable as it explains on a physiological level how TH protects the brain from reperfusion injury and improves neurologic outcomes and survivability. The article defends that TH is the best practice for preventing further neurologic damage after ROSC and provides a clinical example. The clinical example recounts a case in which a patient suffered an out of hospital cardiac arrest. Upon admission to the ICU the therapeutic hypothermia protocol was initiated and the patient was cooled below 35 degrees celcius for 24 hours. After rewarming the patient regained consciousness and within ten days was discharged from the hospital with normal neurologic function and as a survivor (Gardner & MacDonald,
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