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Targeted temperature management (TTM), previously known as therapeutic hypothermia or protective hypothermia, is an active treatment that tries to achieve and maintain a specific body temperature in a person for a specific duration of time in an effort to improve health outcomes during recovery after a period of stopped blood flow to the brain. [1]
A study conducted in 2002-2004 showed that treatment with therapeutic hypothermia for patients resuscitated after cardiac arrest due to ventricular fibrillation led to a positive outcome (Glasgow-Pittsburgh Cerebral Performance category 1 or 2) in 24 of 43 patients compared to only 11 of 43 patients in the standard resuscitation group where no ...
Hypothermia reduces vasogenic oedema, haemorrhage and neutrophil infiltration after trauma. [31] The release of excitatory neurotransmitters is reduced, limiting intracellular calcium accumulation. [ 32 ] [ 33 ] [ 34 ] Free radical production is lessened, which protects cells and cellular organelles from oxidative damage during reperfusion. [ 35 ]
Choice of rewarming method depends on the suspected extent of skin injury and severity of hypothermia (if present). [11] Passive rewarming techniques such as blankets may be sufficient for milder injuries. [11] Active rewarming techniques such as warm intravenous fluids or warm water baths may be needed for more severe injuries.
Rewarming is typically continued until a person's temperature is greater than 32 °C (90 °F). [2] If there is no improvement at this point or the blood potassium level is greater than 12 millimoles per litre at any time, resuscitation may be discontinued. [2] Hypothermia is the cause of at least 1,500 deaths a year in the United States. [2]
While moderate hypothermia may be satisfactory for short surgeries, deep hypothermia (20 °C to 25 °C) affords protection for times of 30 to 40 minutes at the bottom of this temperature range. Profound hypothermia (< 14 °C) usually isn't used clinically. It is a subject of research in animals and human clinical trials.
A hypothermia cap (also referred to as cold cap or cooling cap) is a therapeutic device used to cool the human scalp. Its most prominent medical applications are in preventing or reducing alopecia in chemotherapy , and for preventing cerebral palsy in babies born with neonatal encephalopathy caused by hypoxic-ischemic encephalopathy (HIE) .
It has been well established that maintenance of therapeutic hypothermia is arrest scenarios is beneficial. [22] [23] In view of this, a target temperature of 33° C is maintained for the first 24 hours following commencement of ECMO, with gradual rewarming occurring thereafter. [19]