Therapeutic hypothermia and temperature management
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Ther Hypothermia Temp Manag · Sep 2015
Case ReportsUse of an Intravascular Heat Exchange Catheter and Intravenous Lipid Emulsion for Hypothermic Cardiac Arrest After Cyclobenzaprine Overdose.
In this case report, a 22-year-old male developed severe hypothermia after an accidental overdose of cyclobenzaprine. During transport, the patient developed cardiac arrest. ⋯ Intravenous lipid emulsion (ILE) was also administered. A discussion of cyclobenzaprine toxicity, hypothermia, ILE, and accidental hypothermic cardiac arrest follows.
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Ther Hypothermia Temp Manag · Sep 2015
Effect of Induced Mild Hypothermia on Acid-Base Balance During Experimental Acute Sepsis in Rats.
The aim of this study was to determine the effect of induced mild hypothermia (34°C) on acid-base balance in septic rats. Twenty-eight male Sprague-Dawley rats median weight 306 g, range 251-333 g were used. After anesthesia and when the target temperature was reached (normothermia: 38°C or induced mild hypothermia: 34°C), sepsis was induced by cecal ligation and perforation. ⋯ This increase was less marked at 34°C compared with 38°C. Moreover, sepsis induction led to a marked metabolic acidosis and hypothermia delayed this acidosis. Induced mild hypothermia delays the evolution of cytokines and metabolic acidosis during experimental sepsis.
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Ther Hypothermia Temp Manag · Jun 2015
ReviewInterpreting the results of the targeted temperature management trial in cardiac arrest.
The targeted temperature management (TTM) trial, which found that cooling to 33°C after witnessed cardiac arrest (CA) conferred no benefits compared with 36°C, has led to much debate in the hypothermia community. This article discusses what lessons can be drawn. The TTM trial achieved far better outcomes in controls than any previous randomized controlled trial (RCT) or any nonrandomized study where no fever control was applied. ⋯ It remains to be explained why the TTM results so completely contradict previous studies in this field. These issues should be thoroughly discussed before changes in guidelines and protocols are made. Ending or modifying hypothermia treatment after CA should require the strongest possible evidence.