Therapeutic hypothermia, or cooling, lowers a patient’s body temperature to help reduce the risk of injury to the brain following a period of insufficient blood flow due to an ischemic event, such as cardiac arrest, stroke or traumatic brain injury. Cooling typically begins AFTER the patient is admitted to the hospital. However, many medical professionals believe that cooling could be more effective if started earlier, ideally at the time of arrest, but current hypothermia methods are not practical in this setting.
Two landmark human studies published simultaneously in 2002 by the New England Journal of Medicine demonstrated the positive effects of mild hypothermia applied following cardiac arrest. In response to this research:
- The International Liaison Committee on Resuscitation (ILCOR) released a special advisory statement recommending the use of therapeutic hypothermia following cardiac arrest.
Key Notifications from 2010 Guideline Updates
- Both sets of guidelines now recommend cooling in all rhythms, and in-hospital as well as out-of-hospital cardiac arrests.
- ERC added the statement “Therapeutic hypothermia is now an established therapy that greatly contributes to improved survival with good neurological outcome.” In the 4th link of the Chain of Survival.
- ERC guidelines suggest that “Ultimately, starting cooling during cardiac arrest may be most beneficial—animal data indicate that this may facilitate ROSC.”
- ERC guidelines recognize “Transnasal evaporative cooling” as an appropriate means to induce therapeutic hypothermia.
- AHA guidelines recommend that patients resuscitated from cardiac arrest be transported only to centers that practice therapeutic hypothermia.