Tuesday, July 26, 2011

Review of therapeutic hypothermia after cardiac arrest

Here's a nice update from CCJM with free full text and CME available.

Points of interest:

For neurologically appropriate patients (GCS less than 8) the intervention carries a class I recommendation in the 2010 ACLS guidelines when the cardiac arrest was out of hospital and the initial rhythm was VF or pulseless VT and spontaneous circulation was restored in less than 60 minutes.

For all other rhythms and for in hospital arrest of any rhythm the intervention is given a class IIb recommendation.

Patients without obvious extracardiac cause for their arrest need prompt coronary angiography. Therapeutic hypothermia can be implemented in parallel with cardiac catheterization, with the protocol started before or during the procedure.

All bets are off for estimating neurologic prognosis until 72 hours after rewarming.

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