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Mild Therapeutic Hypothemia In Improving Patient Outcomes

1297 words - 6 pages

The purpose of this paper is to review and evaluate two recent studies, published within the last 5 years, conducted on mild therapeutic hypothermia induction in relation to the cardiac and vascular circulation. One article tested and evaluated the effects of mild hypothermia therapy on patients with cardiogenic shock after resuscitation from an out-of-hospital cardiac arrest. The other study provides some insights on hypothermia therapy on cardiac index of postoperative cardiac surgical patients after iced and room-temperature injectates during hypothermic and normothermic body temperatures. Furthermore, since prior studies have concluded that mild hypothermia inductions contributed to improving long-term neurological outcomes, each article discusses the significant benefit of utilizing therapeutic hypothermia, specifically in increasing survival rate after an out-of-hospital sudden cardiac arrest.
According to Joint Commission in 2011, over 290,000 people in the United States experience sudden cardiac arrest each year. The survival rate of victims remains low, and the risk for recurrence yet remains a significant concern for most survivors, where only 7%–8.5% survive (Joint Commission, 2011). If resuscitation efforts fail to restore cerebral blood circulation within minutes of cardiac arrest, hypoxia may lead to permanent brain injury. Even if circulation is restored, secondary brain damage can occur from direct tissue injury or blood–brain barrier disruption (Michelle et al, 2011). Thus, in an attempt to improve survival rates, prevent permanent neurologic injury and reduce mortality for survivors of cardiac arrest, clinical experiments have shown that a mild hypothermia state of about 32°C to 34°C reduces metabolic and oxygen consumption (Michelle et al, 2011). In addition, it also counteracts neuroexcitation, stabilizes the blood-brain barrier, and suppresses the inflammatory process, and this all in turn markedly improve patient outcomes (Michelle et al, 2011).
In a study article by Zobel et al (2012), the researcher team aimed on testing the hypothesis that cardiogenic shock patients might benefit from mild therapeutic hypothermia. Despite advances in resuscitation and early revascularization strategies, mortality rate from cardiogenic shock after out-of-hospital cardiac arrest have not changed much (Zobel et al. 2012). Since a number of studies suggested mild therapeutic hypothermia helps reduce mortality in cardiac arrest survivors, this research team conducted their study to determine the effects of mild therapeutic hypothermia in patients with cardiogenic shock after resuscitation from out-of-hospital cardiac arrest (Zobel et al. 2012).
The researchers investigated the hemodynamic effect of 20 consecutive patients treated with hypothermia after admitted for cardiogenic shock and compared the results with a control group of 20 historic propensity-scored patients treated under normathernic condition in an emergency medical center...

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