Treatment of Therapeutic Hypothermia

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.

Malignant Hyperthermia is primarily thought to be an autosomal dominant genetic disorder that causes a hypermetabolic state after administration of volatile anesthetics. When a patient is under anesthesia, the muscles are usually relaxed, but when a patient is experiencing Malignant Hyperthermia crisis, certain IV anesthesia causes the opposite effect. Most inhaled anesthetics other than nitrous oxide, cause or trigger Malignant Hyperthermia. More specifically, the anesthetic agents: Halothane, Chloroform, and Succinylcholine. The genic condition of Malignant Hyperthermia only becomes apparent when a patient is exposed to certain anesthetics such as halothane, which causes muscle rigidity.

THT is the only therapy that has appeared to positively affect the neurological outcome of patients after cardiac arrest. THT has been around for more than fifty years. The history of the scope of THT is limited and the only consistent application of this therapy invasive surgery. Within the last 10 years, the benefits of induced therapeutic hypothermia have been rediscovered, mainly with the improvement in neurological outcomes in out-of-hospital cardiac arrest (OOHCA) victims. In addition, therapeutic hypothermia has been suggested to improve outcome in other neurological conditions such as traumatic brain injury, neonatal asphyxia, cerebrovascular accidents and intracranial

Markus Thalmann, the cardiac surgeon who saved the little girl from death by drowning in icy water, said that she was not the first hypothermia and suffocation case. However, she was the first one to survive. In her complicated rescue they tried to follow a checklist that stats that in such a case, a rescue team was required to tell the hospital to prepare for possible cardiac bypass and rewarming. So, what was so effective about this approach is that by the time the patient gets to the hospital, everything is ready and standing by. These kinds of cases are time sensitive. In such complicated cases, success requires having a huge number of equipment and people at the ready. So, even small simple checklist could help in complicated rescues and even bring people to life

The evidence surrounding the topic of therapeutic hypothermia post cardiac arrest is one lathered in potentially advantageous benefits, as well as harmful side effects. Although this procedure has potentially lifesaving and neurologically preserving implications, it does come with various side effects which can be dangerous in general or if left untreated. This paper will first address the many benefits, some of which include prolongation of life, retention of neurological function. It will then shed light upon some of the subsequent risks and harmful effects that are associated with therapeutic hypothermia. Lastly the paper will discuss why or why not the overall benefits outweigh the aggravating factors. Thus, being a topic of much controversy

Malignant hypertension is an inherited condition. It occurs when the patient has a severe reaction caused by being exposed to certain drugs used as a part of the anesthesia for surgical procedures. It can be fatal if it is not treated quickly. In most cases, there are no signs or symptoms until the reaction occurs.

The American Heart Association (2011) states that, "Therapeutic hypothermia is the only intervention demonstrated to improve neurologic recovery after cardiac arrest" (Pp 77). Recommendations range between 32 and 36 degrees centigrade for 12 to 36 hours. Cooling may be achieved through either introduction of cooled, isotonic, non-glucose-containing fluid, or surface cooling interventions like ice packs or cold packs. The AHA states, however, that patient core temperature must be monitored by an esophageal thermometer, a pulmonary artery catheter, or a bladder catheter and that peripheral temperature measurements via axillary, aural, or oral thermometers are inadequate for measuring core temperatures in targeted temperature management. Therefore, while the AHA does recommend initiation of therapeutic hypothermia by EMS personnel in certain situations, agencies must carry--and be trained in the use of--equipment to adequately measure the patient 's core temperature. Further, the AHA states that therapeutic hypothermia results in increased neurologic function post-cardiac-arrest but does not identify a timeframe for initiation for these protocols, let alone explore whether or not initiation of post-cardiac-arrest targeted temperature management by EMS influences patient outcomes.

Therapeutic hypothermia, also called targeted temperature management, is a procedure that lowers the body's temperature in order to treat a heart that has suddenly stopped working (cardiac arrest). This procedure is used in emergency situations. During cardiac arrest, the brain cannot get enough oxygen. The brain also starts to swell, which can damage or kill brain cells. Therapeutic hypothermia helps reduce swelling in the brain. It also slows down the body's metabolism and allows the heart and brain to recover.

Malignant hypothermia is a disease, caused by a bad reaction of anesthetics. This disease causes an immensely rapid temperature rise and extreme muscle contractions. MH (malignant hypothermia) is passed down through families and inherited by one parent carrying it giving it to the child. “Malignant hyperthermia occurs in 1 in 5,000 to 50,000 instances in which people are given anesthetic gases” (NIH, 2007). Most people aren’t aware that they are prone to this disease/reaction because they have never been under anesthesia drugs, or have never received surgery.

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,

Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies.

The implementation of advanced emergency management (drugs, endotracheal intubation) and post-cardiac arrest care (therapeutic hypothermia, coronary intervention) was also investigated. A total of 4,156

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.

Cryotherapy is a medical procedure that involves the utilization of extreme cold to destroy any abnormal growth on the skin. It is used to alleviate skin disease such as warts, moles, skin tags, and solar keratoses. Cryotherapy is considered one of the most effective treatments for genital warts. The said procedure can only be done at a doctor's office.