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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]
Hypothermia appears to have multiple effects at a cellular level following cerebral injury. Hypothermia reduces vasogenic oedema, haemorrhage and neutrophil infiltration after trauma. [31] The release of excitatory neurotransmitters is reduced, limiting intracellular calcium accumulation.
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 ...
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.
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) .
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.
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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]