Too cold may not be so cool: spontaneous hypothermia as a marker of poor outcome after cardiac arrest

Abstract

In a recent issue of Critical Care, den Hartog and colleagues show an association between spontaneous hypothermia, defined by an admission body temperature <35°C, and poor outcome in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Given that TH alters neurological prognostication, studies aiming to identify early markers of injury severity and outcome are welcome, since they may contribute overall to optimize the management of comatose CA patients. This study provides an important message to clinicians involved in post-resuscitation care and raises important questions that need to be taken into account in future studies.

Phase-Changing Glauber Salt Solution for Medical Applications in the 28–32 °C Interval

“…By controlled therapeutic hypothermia (cooling of the human body) to a stable temperature of 33.5 ± 0.5 °C, children at risk of nHIE have been shown to have a reduced risk of death or severe disability at 18–22 months follow-up, based on several randomized, controlled investigations [ 16 , 17 , 18 , 19 ], after extensive pre-studies [ 20 , 21 , 22 ]. Nevertheless, there is a need to further investigate and assess several aspects of this complex therapy [ 19 , 23 , 24 , 25 ], and not to cool too much [ 26 , 27 ], as well as to clarify how the brain responds and how the effects of cooling in combination treatments, such as addition of Xenon gas, operate [ 28 ]. A key factor influencing the therapeutic effect of hypothermia is the interval between the insult and the induction of hypothermia [ 20 , 21 ].…”