Therapeutic hypothermia after cardiac arrest – implementation in UK intensive care units*

Binks, Andrea; Murphy, Robert E.; Prout, Rachel; Bhayani, Sadiq; Griffiths, Christopher; Mitchell, Thomas A.; Padkin, Andrew; Nolan, Jerry P.

doi:10.1111/j.1365-2044.2009.06227.x

Cited by 62 publications

(26 citation statements)

References 27 publications

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“…Public health officials in the city of New York have passed regulations that will allow emergency medical service personnel to transport cardiac arrest patients to hospitals that provide therapeutic hypothermia, even if this requires bypassing other hospitals that have emergency facilities but do not cool (48). Recent reports from the Netherlands (49) and from the United Kingdom (50) document that the routine use of therapeutic hypothermia in the intensive care unit after cardiopulmonary resuscitation has risen to 92% and 85.6%, respectively, by doctors and hospitals.…”

Section: Clinical Applications Of Therapeutic Hypothermia: the Presentmentioning

confidence: 99%

State of the Art in Therapeutic Hypothermia

2011

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Historically, hypothermia was induced prior to surgery to enable procedures with prolonged ischemia, such as open heart surgery and organ transplant. Within the past decade, the efficacy of hypothermia to treat emergency cases of ongoing ischemia such as stroke, myocardial infarction, and cardiac arrest has been studied. Although the exact role of ischemia/reperfusion is unclear clinically, hypothermia holds significant promise for improving outcomes for patients suffering from reperfusion after ischemia. Research has elucidated two distinct windows of opportunity for clinical use of hypothermia. In the early intra-ischemia window, hypothermia modulates abnormal cellular free radical production, poor calcium management, and poor pH management. In the more delayed post-reperfusion window, hypothermia modulates the downstream necrotic, apoptotic, and inflammatory pathways that cause delayed cell death. Improved cooling and monitoring technologies are required to realize the full potential of this therapy. Herein we discuss the current state of clinical practice, clinical trials, recommendations for cooling, and ongoing research on therapeutic hypothermia.

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Section: Clinical Applications Of Therapeutic Hypothermia: the Presentmentioning

confidence: 99%

State of the Art in Therapeutic Hypothermia

2011

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“…In a recent trial of an impedance threshold device for OHCA in the United States and Canada, just 48% of the 2289 enrolled patients admitted hospital were treated with therapeutic hypothermia [48]. On the other hand, in the UK 86% of intensive care units had implemented hypothermia by 2009 [49]. Lack of resources and cost of MTH are commonly cited as barriers to implementation, despite relatively cheap options being available.…”

Section: Hypothermiamentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest –Optimal Management

Fröhlich¹,

Lyon²,

Sasson³

et al. 2014

CCR

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Out-of-hospital cardiac arrest (OHCA) has attracted increasing attention over the past years because outcomes have improved impressively lately. The changes for neurological intact outcomes has been poor but several areas have achieved improving survival rates after adjusting their cardiac arrest care. The pre-hospital management is certainly key and decides whether a cardiac arrest patient can be brought back into a spontaneous circulation. However, the whole chain of resuscitation including the in-hospital care have improved also. This review describes aetiologies of OHCA, risk and potential protective factors and recent advances in the pre-hospital and in-hospital management of these patients.

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“…In a recent trial of an impedance threshold device for OHCA in the USA and Canada, just 48% of the 2289 enrolled patients admitted to hospital were treated with therapeutic hypothermia 30. On the other hand, in the UK 86% of intensive care units (ICUs) had implemented hypothermia by 2009 31. Lack of resources and cost of MTH are commonly cited as barriers to implementation, despite relatively cheap options being available.…”

Section: Therapeutic Hypothermiamentioning

confidence: 99%

Advances in the hospital management of patients following an out of hospital cardiac arrest

Nolan

Lyon

Sasson

et al. 2012

Heart

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The outcome for patients after an out-of-hospital cardiac arrest (OHCA) has been poor over many decades and single interventions have mostly resulted in disappointing results. More recently, some regions have observed better outcomes after redesigning their cardiac arrest pathways. Optimised resuscitation and prehospital care is absolutely key, but in-hospital care appears to be at least as important. OHCA treatment requires a multidisciplinary approach, comparable to trauma care; the development of cardiac arrest pathways and cardiac arrest centres may dramatically improve patient care and outcomes. Besides emergency medicine physicians, intensivists and neurologists, cardiologists are playing an increasingly crucial role in the post-resuscitation management, especially by optimising cardiac output and undertaking urgent coronary angiography/intervention.

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Therapeutic hypothermia after cardiac arrest – implementation in UK intensive care units*

Cited by 62 publications

References 27 publications

State of the Art in Therapeutic Hypothermia

State of the Art in Therapeutic Hypothermia

Out-of-Hospital Cardiac Arrest –Optimal Management

Advances in the hospital management of patients following an out of hospital cardiac arrest

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