When, where and how to initiate hypothermia after adult cardiac arrest

摘要: Therapeutich hypothermia (TH) has been shown to improve neurological outcome and survival after witnessed cardiac arrest (CA) that is due ventricular fibrillation. Although TH widely used following CA as well all forms of initial rhythm, the mortality rate remains unacceptably high, additional study needed understand when how implement in post-resuscitation phase. Experimental studies have emphasized importance initiating cooling soon return spontaneous circulation (ROSC) or even during cardiopulmonary resuscitation (CPR). Clinical pre-hospital induction feasible no major adverse events-even intra-arrest-and may provide some benefits compared delayed in-hospital cooling. Thus, use should not be limited Intensive Care Unit but can initiated field/ambulance Emergency Department, then continued hospital admission- specific procedures such coronary angiography-as part global management patients. Various methods (both non-invasive invasive) are available achieve maintain target temperature; however, only these methods-which include cold fluids, ice packs, iced pads helmet trans-nasal cooling- easily deployed setting.