Therapeutic hypothermia and temperature management
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Ther Hypothermia Temp Manag · Dec 2017
ReviewTherapeutic Hypothermia for Asphyxial Out-of-Hospital Cardiac Arrest Due to Drowning: A Systematic Review of Case Series and Case Reports.
The objective of this review was to summarize published evidence of the effectiveness of therapeutic hypothermia in patients with drowning-associated asphyxial out-of-hospital cardiac arrest (OHCA) and to explore any preliminary favorable factors in the management of therapeutic hypothermia to improve survival and neurological outcome. Drowning may result in asphyxial OHCA or hypothermic OHCA, but the former does not provide any potential neuroprotective effect as the latter may do. Electronic literature searches of Ovid Medline, Embase, Cochrane Library, and Scopus were performed for all years from inception to July 2016. ⋯ Future research should put effort on RCT, particularly the effect of extended duration of 48-72 hours. Important parameters should be reported in detail. Asphyxial and hypothermic OHCA should be differentiated.
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Ther Hypothermia Temp Manag · Dec 2017
Targeted Temperature Management Effectiveness in the Elderly: Insights from a Large Registry.
Targeted temperature management (TTM) is recommended for all comatose adult out-of-hospital cardiac arrest (OHCA) patients with shockable first documented rhythm. However, studies examining the use and benefits of TTM among patients aged 75 and older are lacking. Using the Cardiac Arrest Registry to Enhance Survival (CARES) dataset registry from 2013 to 2015. ⋯ Propensity score results showed a modest association with TTM and increased mortality (OR) = 1.22, 95% CI [1.01-1.47]; p = 0.036 and no association with poor neurologic outcome (OR = 1.18; 95% CI [0.82-1.69]; p = 0.379) in the elderly. TTM is often provided to OHCA patients over age 75 though the benefits, particularly among nonshockable first documented rhythm patients are unclear. A randomized trial is needed to definitively answer who among OHCA event survivors aged 75 and older should receive this treatment.