A Retrospective Study on the Initiation and Maintenance of Therapeutic Hypothermia after Cardiac Arrest. Are Simple Guidelines Easy to Follow?

Abstract

Background: Patients surviving a cardiac arrest often suffer debilitating neurological injury as a result of anoxic brain damage. Recent studies have demonstrated improved neurological outcome in cardiac arrest patients undergoing 12–24 hours of mild hypothermia. Reviewing the results from such studies the International Liaison Committee on Resuscitation has issued guidelines on hypothermia treatment in survivors of cardiac arrest. Aims: To determine the feasibility of a treatment protocol implementing the International Liaison Committee on Resuscitation guidelines on therapeutic hypothermia after cardiac arrest. Methods: A one-year retrospective analysis of cardiac arrest patients assigned to hypothermia treatment in an Intensive Care Unit. Results: Fifteen patients were assigned to hypothermia after cardiac arrest. No adverse side effects were observed as a result of the cooling procedure. The length of time to initiate and maintain cooling was the major deviation from the protocol. Conclusion: We recommend that hypothermia should be commenced as early as possible by using cold intravenous crystalloids. This is a safe procedure that can be done after the immediate resuscitation.