Therapeutic Hypothermia in the ICU: The Nursing Aspect

Papageorgiou, Dimitris; Tsikritsaki, Katerina; Javed, Faresh; Stathopoulos, Theodoros; Ntinou, Evaggelia; Mavrogenis, Andreas F.; Koukoulitsios, George

doi:10.1615/jlongtermeffmedimplants.2017019969

Cited by 3 publications

(1 citation statement)

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“…57 From a nursing perspective, endovascular cooling had the best rating with regard to ease of temperature monitoring and least additional workload. 58 In terms of adverse effects, endovascular cooling may be a risk factor for venous catheter-related thrombosis. 59 However, a post-hoc analysis of the TTM trial 60 showed a tendency towards a better neurologic outcome, and a recent meta-analysis revealed that endovascular cooling was associated with improved neurological outcomes at discharge.…”

Section: Systemic Coolingmentioning

confidence: 99%

Targeted temperature management and early neuro-prognostication after cardiac arrest

Chen

Lachance

Gao

et al. 2021

J Cereb Blood Flow Metab

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Targeted temperature management (TTM) is a recommended neuroprotective intervention for coma after out-of-hospital cardiac arrest (OHCA). However, controversies exist concerning the proper implementation and overall efficacy of post-CA TTM, particularly related to optimal timing and depth of TTM and cooling methods. A review of the literature finds that optimizing and individualizing TTM remains an open question requiring further clinical investigation. This paper will summarize the preclinical and clinical trial data to-date, current recommendations, and future directions of this therapy, including new cooling methods under investigation. For now, early induction, maintenance for at least 24 hours, and slow rewarming utilizing endovascular methods may be preferred. Moreover, timely and accurate neuro-prognostication is valuable for guiding ethical and cost-effective management of post-CA coma. Current evidence for early neuro-prognostication after TTM suggests that a combination of initial prediction models, biomarkers, neuroimaging, and electrophysiological methods is the optimal strategy in predicting neurological functional outcomes.

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