Advance In Therapeutic Hypothermia On Cardio-Pulmonary Resuscitation After Adult Cardiac Arrest

Summary: The high incidence of heart attacks and low survival rate is a serious threat to human health. Research shows that therapeutic hypothermia is expected to improve neurological recovery of patients after cardiopulmonary resuscitation (CPR).So far the exactly mechanisms of hypothermic neroprotection has not been completely clarified yet. However, practical aspects of therapeutic hypothermia are controversial.Purpose: This review summarizes the advance in practical aspects of therapeutic hypothermia on CPR after adult cardiac arrest(CA).Content: The guidelines recommend that comatose adult patients with return of spontaneous circulation (ROSC) after out-of-hospital ventricular fibrillation(VF) cardiac arrest should be cooled to 32°C to 34°C for 12 to 24 hours.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 electricactivity or asystole. Studies suggested that time to initiation of cooling and time to achieving target temperature were not associated with improved neurological outcome after discharge. Studies also documented that time to target temperature was not an independent predictor of neurological outcome. Providers should closely monitor patient core temperature after ROSC and actively intervene to avoid hyperthermia and other complications.Trend: Therapeutic hypothermia is one of important measures for cerebral protection after CPR patients.It's still need a lot of evidence-based studys for application in time,mode,duration and adverse reactions of prevention.