Community-Based Application of Mild Therapeutic Hypothermia for Survivors of Cardiac Arrest

Abstract

A simple protocol of mild therapeutic hypothermia using locally available resources is technically feasible and safe in a community-based setting.

Safety profile and outcome of mild therapeutic hypothermia in patients following cardiac arrest: systematic review and meta-analysis

“…Some studies reported that the body temperature of a few patients receiving MTH reached below 32°C, indicating overcooling 26 28 36 40 57 59 63 71…”

“…Compared with endovascular cooling, simple surface cooling seems to be associated with greater temperature fluctuations and more frequent overcooling, which may result in serious complications,32 although seldom reported. However, endovascular cooling and surface cooling with automatic feedback system could provide more stable temperature maintenance 36 71. Several cooling methods can be used in clinical practice.…”

Therapeutic Hypothermia after Cardiac Arrest: Experience at an Academically Affiliated Community-Based Veterans Affairs Medical Center

“…In spite of this growing body of literature, therapeutic hypothermia has not been universally accepted and pursued at all medical centers [19], with cited barriers including lack of institutional protocols, resources, and limited prior experience [20]. Some authors have called upon neurologists to become more active in management of these patients beyond offering prognosis and in helping create hospital-wide policies given that therapeutic hypothermia remains one of the only proven treatments for improving neurologic outcome [21], and a recent report from Prior and colleagues demonstrated the success of planning and implementing a therapeutic hypothermia protocol in a community-based hospital setting [20].…”

“…Some authors have called upon neurologists to become more active in management of these patients beyond offering prognosis and in helping create hospital-wide policies given that therapeutic hypothermia remains one of the only proven treatments for improving neurologic outcome [21], and a recent report from Prior and colleagues demonstrated the success of planning and implementing a therapeutic hypothermia protocol in a community-based hospital setting [20]. As such, in this retrospective analysis, we report our experience with implementation of therapeutic hypothermia for comatose cardiac arrest survivors and its outcomes in an academically affiliated community-based Veterans Affairs medical center in which the majority of events were in-hospital.…”

Urban and Suburban Hospital System Implementation of Multipoint Access Targeted Temperature Management in Postcardiac Arrest Patients

“…This eliminated the delay of staff checking with one individual before implementing the process. Time metrics for the induction phase improved with increased Code ICE experiences ( Jimmink et al, 2008;Kilgannon et al, 2008;Prior et al, 2010;Shah et al, 2011;Gessner et al, 2012). This pattern is consistent with better provider and patient outcomes with increased patient volumes (Nichol et al, 2010).…”