Standardizing post cardiac arrest protocols: A review of therapeutic hypothermia and the possibility of creating standardized post cardiac arrest protocols

Problem: Although return of spontaneous circulation (ROSC) following cardiac arrest has increased, survival with good neurological outcome is poor. Post cardiac arrest syndrome has been described as the physiological events that occur after restoration of circulation. Hyperthermia is a major cause of mortality and morbidity in post cardiac arrest syndrome and therapeutic hypothermia is an effective treatment to combat hyperthermia and preserve neurological function. Although evidence proves the effectiveness of therapeutic hypothermia versus traditional treatment, it is still not widely used and no standard guidelines exist for its use. Methods: Peer-reviewed clinical trials within the last fifteen years that were relevant to using therapeutic hypothermia post cardiac arrest and the use of standardized protocols in cardiac arrest management were included in the literature review. Results: Every study analyzed concluded that therapeutic hypothermia is an efficacious treatment for post cardiac arrest syndrome. Therapeutic hypothermia was found to be beneficial for decreasing mortality and improving neurological outcome post cardiac arrest and was achieved successfully using a variety of methods. The use of therapeutic hypothermia is still low, despite current AHA and ILCOR recommendations. Goal oriented and bundled care has proven to have a significant impact on reducing morbidity and mortality from cardiac arrest. Conclusions: Further research on the use of a comprehensive standardized post cardiac arrest treatment protocol inclusive of therapeutic hypothermia will likely significantly improve efficiency in treatment and positive outcomes following cardiac arrest.