2. Case Presentation
● 46 yo woman w PMH of HTN p/w witnessed OHCA one
hour ago, she has ROSC after shocked when in VF
rhythm, but has no return of consciousness.
Bystanders state she was complaining of chest pain.
● Vital signs are within normal limits. PE is normal wtih
no signs of trauma.
● She is sedated and intubated, IV access, ECG does not
show signs of ischemia, trops, glucose, electrolytes,
other labs, and CXR are normal
3. Things to Consider
● What's the goal temperature in therapeutic
hypothermia?
● List the phases of therapeutic hypothermia
● What are the mechanisms by which therapeutic
hypothermia exerts neuroprotection?
4. ●
The temperature goal is around 32o-34o C
● Phases of therapeutic hypothermia
– Induction: onset, rate, and target temperature
– Maintenance: duration and temperature control
– Rewarming: different approaches, but slow rate
● Neuroprotection:
– Decreases brain metabolism
– Slows down cell death
– Reduction of free radical production
– Decrease inflammatory response
– Protects the blood brain barrier
5. Reference
Therapeutic Hypothermia After Cardiac Arrest in Adults:
Mechanism of Neuroprotection, Phases of Hypothermia, and
Methods of Cooling
Yinlun Weng, MD, Shijie Sun, MD
Critical Care Clinics; Vol 28; issue 2; (April 2012) p.231-43
