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  • Postgraduate medicine · Jan 2010

    Review Historical Article

    Therapeutic hypothermia: implications for acute care practitioners.

    • Joseph Varon.
    • The University of Texas Health Science Center at Houston, 2219 Dorrington St., Houston, TX 77030, USA. joseph.varon@uth.tmc.edu
    • Postgrad Med. 2010 Jan 1;122(1):19-27.

    AbstractThe use of therapeutic hypothermia (TH) in acute care medicine has evolved over the past 2 centuries, and its use over the past decade has increased in emergency departments, intensive care units, and operating rooms. Therapeutic hypothermia has several potential clinical applications based on its putative mechanisms of action. It appears to improve oxygen supply to ischemic areas of the brain and decreases intracranial pressure. Mild-to-moderate TH (33 degrees C +/- 1 degrees C) after resuscitation from cardiac arrest is neuroprotective, and also acts on the cardiovascular system with evidence of a decrease in heart rate and increase in systemic vascular resistance. Therapeutic hypothermia decreases cardiac output by 7% for each 1 degrees C decrease in core body temperature, but maintains the stroke volume and the mean arterial pressure. Despite a growing amount of data, this life-saving technique is underutilized in hospitals worldwide. The purpose of this comprehensive review is to show the evolution and the clinical use of TH as it pertains to acute care practitioners.

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