Therapeutic hypothermia and temperature management
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Ther Hypothermia Temp Manag · Sep 2013
Bullous Lesions After Use of a Commercial Therapeutic Hypothermia Temperature Management System: A Possible Burn Injury?
Therapeutic hypothermia (TH) is a novel technique for improving the likelihood of survival with good neurologic outcome after cardiopulmonary arrest. While commercial temperature management systems (TMS) are intended to facilitate cooling of the body during TH, their operation also involves body exposure to heat. ⋯ The patient developed bullous lesions on the thigh and torso suspected to constitute a scald burn injury from the TMS. Clinicians must be aware of this important adverse event when providing TH, especially in the setting of concurrent hemodialysis therapy.
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Ther Hypothermia Temp Manag · Sep 2013
Postarrest targeted temperature management immediately following craniotomy-a case report.
Therapeutic hypothermia or targeted temperature management (TTM) has been shown to improve survival and neurological outcome after cardiac arrest. TTM is not frequently utilized in the postoperative setting because of the concern for exacerbation of bleeding. We present the case of a 65-year-old man who had a cardiac arrest during craniotomy for a brain tumor resection. ⋯ Repeat imaging revealed no additional bleeding. The patient was discharged with a cerebral performance category of 1 to an acute rehabilitation center 11 days following his cardiac arrest. This case highlights the need for further consideration of TTM in the postoperative cardiac arrest population.
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Ther Hypothermia Temp Manag · Jun 2013
Postanoxic status epilepticus can be identified and treatment guided successfully by continuous electroencephalography.
Prognostication after cardiac arrest and therapeutic hypothermia is challenging. Recent data indicate that a subgroup of patients with postanoxic status epilepticus may recover. We describe a case of postanoxic status epilepticus with good outcome where a multimodal prognostic strategy motivated active and prolonged treatment. ⋯ We conclude that a favorable neurological outcome is possible despite prolonged postanoxic status epilepticus. A multimodal strategy for prognostication may help identify treatable cases. Continuous EEG monitoring is an important tool to detect and guide treatment of postanoxic status epilepticus.
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Treatment with mild hypothermia induced after cardiopulmonary resuscitation has become a standard of care, but optimal timing and duration of hypothermia remains unclear. We present a 66-year-old man admitted after an out-of-hospital cardiac arrest. ⋯ As a result, the patient was kept at the goal hypothermic temperature of 33°C for a total of 48 hours, compared with the usual 24-hour standard, with excellent sustained neurological recovery. This case documents the usefulness of extending hypothermia when applied to severely unstable patients and suggests that a sliding-target approach may be applied on a patient-by-patient basis.