Managing Hypothermia in Cardiac Arrest and Rewarming

Abstract

Many institutions are currently utilizing therapeutic hypothermia to target cardiac arrest as well as different types of brain injuries. Confounding issues including accidental hypothermia as well as the need to carefully rewarm patients with some types of physiological monitoring strategies are an area of active investigation and discussion. This particular session brought together experts in the field from cardiology, surgery, and trauma to discuss current strategies for managing hypothermia and temperature maintenance in various patients with different types of disorders. Dr. Eric Zoog, medical director of the Emergency Department, Mississippi Baptist Medical Center, provided an interesting summation of how he and his colleagues developed a successful hypothermia program in a community hospital. Several important points were made in terms of the processes, including convincing various services to help with this important program. Dr. Robert Silbergleit, Department of Emergency Medicine, University of Michigan Health System, discussed his experience in various clinical trials, including the use of hypothermia in cardiac arrest as well as patients undergoing aneurysm surgery. His experience emphasized the importance of introducing careful strategies to monitor brain function during cooling and rewarming phases. Dr. Josh Levine, Department of Neurology, University of Pennsylvania, discussed the use of hypothermia in various brain injury conditions. Most importantly, he and his colleagues have been investigating the importance of developing surrogate biomarkers that could aid in the assessment of the status of the brain. Most importantly, these biomarkers could be used to individualize treatments based on active processes. This session had a very interesting question-and-answer exchange, again emphasizing the interest in using therapeutic hypothermia and temperature management strategies during various emergency situations.