RT Book, Section
A1 Gaieski, David F.
A1 Goyal, Munish
A2 Farcy, David A.
A2 Chiu, William C.
A2 Flaxman, Alex
A2 Marshall, John P.
SR Print(0)
ID 55816193
T1 Chapter 50. Therapeutic Hypothermia: History, Data, Translation, and Emergency Department Application
T2 Critical Care Emergency Medicine
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-162824-2
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=55816193
RD 2024/04/16
AB Therapeutic  hypothermia  (TH)  has  become  standard  of  care  for  the  management  of  comatose  patients  with  return  of  spontaneous  circulation  (ROSC)  after  cardiac  arrest.  The  2010  American  Heart  Association  (AHA)  guidelines  for  management  of  post–cardiac  arrest  patients  “recommend  that  comatose  (i.e.,  lack  of  meaningful  response  to  verbal  commands)  adult  patients  with  ROSC  after  out-of-hospital  ventricular  fibrillation  (VF)  cardiac  arrest  should  be  cooled  to  32°C  to  34°C  (89.6°F  to  93.2°F)  for  12  to  24  hours  (Class  I,  LOE  B).  Induced  hypothermia  also  may  be  considered  for  comatose  adult  patients  with  ROSC  after  in-hospital  cardiac  arrest  of  any  initial  rhythm  or  after  out-of-hospital  cardiac  arrest  with  an  initial  rhythm  of  pulseless  electric  activity  or  asystole  (Class  IIb,  LOE  B).”1  Very  few  recommendations  in  the  AHA  guidelines  are  assigned  a  Class  I  recommendation,  and,  as  practitioners  at  the  portal  of  entry  for  the  majority  of  cardiac  arrest  patients,  emergency  physicians  (EPs)  need  to  be  familiar  with  this  therapy  and  the  rationale  for  the  level  of  recommendation  assigned  to  TH.