Is it worth packing the head with ice in patients undergoing deep hypothermic circulatory arrest

摘要: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is it worth packing the head with ice patients undergoing deep hypothermic circulatory arrest (DHCA)? Altogether more than 34 papers were found using reported search, of which 7 represented answer clinical question, 5 animal studies, 1 theoretical laboratory study and looked at ability cool circulating water ‘jackets’ humans. There no available human studies looking neurological outcome or without topical cooling further adjunct methods cerebral protection. authors, journal, date country publication, patient group studied, type, relevant outcomes results these are tabulated. Four studied animals DHCA for 45 min–2 h depending on design, ice. all demonstrated improved when packed during DHCA. They also illustrated an outcome, better behavioural scores (P< 0.05), some, survival, compared whose heads not One examined selective use rewarming after However, they worse animals, possibly due loss vasoregulation oedema. involved experiment showing cryotherapy braces by extrapolated that newer devices may improve final discussed here humans pulmonary endarterectomy. tympanic membrane temperatures could be maintained significantly lower bladder rectal head. We conclude is but following possible advance techniques rather