Induced hypothermia after cardiopulmonary resuscitation: possible adverse effects
DOI: 10.22514/SV21.042007.3 Vol.2,Issue 1,April 2007 pp.15-17
Published: 20 April 2007
Department of Surgery,
University Hospital Dubrava Zagreb;Department of anesthesiology, reanimatology and intensive
University Hospital Dubrava, Zagreb
The last several years have seen an increased interest in the use of induced hypothermia after witnessed cardiopulmonary resuscitation (CPR). The main reason for its use is protection of the brain and hence, better neurological outcome in these patients. Therefore, induced hypothermia after CPR has become a part of standard recommendations in the 2005 Resuscitation Guidelines. At the same time, hypothermia can have many adverse effects. In the event of pre-hospital and/or in-hospital induction of hypothermia, without adequate monitoring and controlled cooling, hypothermia can cause serious complications, without beneficial effects on the brain. This article explains the most frequent adverse effects of hypothermia and possible hazardous outcomes for patients.
cardiopulmonary resus-citation, hypothermia, hemodynam-ics
RUDOLF MILANOVIC,SANJA HUSEDZINOVIC,NIKOLA BRADIC. Induced hypothermia after cardiopulmonary resuscitation: possible adverse effects. Signa Vitae. 2007. 2(1);15-17.
1. Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G. European Resuscitation Council Guidelines for Resuscitation 2005. Section 4. Adult advanced life support S39-86.
2. The hypothermia after cardiac arrest study group. Mild therapeutic hypothermia to improve the neurological outcome after cardiac arrest. N Eng J Med 2002;346:549-556.
3. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Eng J Med 2002;346:557-563.
4. Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001;104:2158-2163.
5. Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, and ALS Task Force. Therapeutic hypothermia after cardiac arrest. An advisory state-ment by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation. Resuscitation 2003;57:231-235.
6. Riishede L, Nielsen-Kudsk F. Myocardial effects of adrenaline, isoprenaline and dobutamine at hypothermic conditions. Pharmacol Toxicol 1990;66(5):354-360.
7. Strohmenger HU, Hemmer W, Lindner KH, Schickling J, Brown CG. Median fibrillation frequency in cardiac surgery: influence of tempera-ture and guide to countershock therapy. Chest 1997;111:1560-1564.
8. Larach MG. Accidental hypothermia. Lancet 1995;345:490-498.
9. Lloyd EL. Accidental hypothermia. Resuscitation 1996;32:111-134.
10. Delaney K. Hypothermic sudden death. In: Paradis N, Halperin HR, Nowak RM, eds. Cardiac Arrest. Baltimore, Philadelphia: Williams & Wilkins 1996:745-760.
11. Ujhelyi MR, Sims JJ, Dubin SA, Vender J, Miller AW. Defibrillation energy requirements and electrical heterogeneity during total body hypothermia. Crit Care Med 2001;29(5):1006-1011.
12. Schwarz B, Mair P, Wagner-Berger H, Stadlbauer KH, Girg S, Wenzel V, Lindner KH. Neither vasopressin nor amiodarone improve CPR outcome in an animal model of hypothermic cardiac arrest. Acta Anaesthiol Scand 2003;47:1114-1118.
13. Kliegel A, Lorset H, Sterz F, Kliegel M, Holzer M, Uray T, Domanovits H. Cold simple intravenous infusions preceding special endovascular cooling for faster induction of mild hypothermia after cardiac arrest - a feasibility study. Resuscitation 2005;64:347-351.
14. Kudenchuk PJ, Cobb LA, Copass MK, Cummins RO, Doherty AM, Fahrenbruch CE, Hallstrom AP, Murray WA, Olsufka M, Walsh T. Amio-darone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 1999;341:871-878.
15. Kudenchuk PJ. Intravenous antiarrhythmic drug therapy in the resuscitation from refractory ventricular arrhythmias. Am J Cardiol 1999;84:52R-55R.
16. Kurtz A, Sessler DI, Birnbauer F, Illievich U, Spiss C. Thermoregulatory vasoconstriction impairs active core cooling. Anesthesiology 1995;82:870-876.
17. Rajek A, Greif R, Sessler DI, Baumgardner J, Laciny S, Bastanmehr H. Core cooling by central venous infusion of ice-cold (4°C and 20°C) fluid. Anesthesiology 2000;93:629-637.
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