Potential role of therapeutic hypothermia in the salvage of traumatic hemorrhagic shock

Abstract

Although therapeutic hypothermia could serve as a potential therapeutic strategy for treatment of traumatic hemorrhagic shock, significant controversy exists regarding its safety and feasibility. The current resuscitation strategy in traumatic hemorrhagic shock may also require updating. In this article, we have carried out an extensive literature search in this field and propose an initial algorithm for use of therapeutic hypothermia in traumatic hemorrhagic shock. This work lays essential groundwork for future investigations in this field.

Ideal target arterial pressure after control of bleeding in a rabbit model of severe traumatic hemorrhagic shock: results from volume loading-based fluid resuscitation

“…A stepwise way of increasing fluid volume and/or MAP might be advisable and has been proposed by us and others [20,21]. In a dog model of myocardial ischemia, gradual reperfusion reduced infarct size and preserved endothelial function [22].…”

Therapeutic Hypothermia and the Risk of Hemorrhage

“…Furthermore, it should also be emphasized that actively bleeding patients or patients with bleeding diathesis were excluded from most clinical trials studying TH, and generalization of our result should be cautiously weighed against the benefits of cooling. Nevertheless, the potential role of TH in the treatment of traumatic hemorrhagic shock is under investigation in clinical trials, 79 which might shed light on this important issues more clearly.…”

MicroRNA‐155 potentiates the inflammatory response in hypothermia by suppressing IL‐10 production

“…Furthermore, hypothermia is commonly used in cardiac and vascular surgery during complicated reconstructions of the aortic arch to diminish the effects of hypoxia during circulatory arrest (3). Because of such clinical utility, therapeutic hypothermia is currently under investigation for its use in other common clinical scenarios in which local tissue hypoxia may occur, such as spinal cord injuries and hemorrhagic shock (4, 5).…”