Therapeutic
Hypothermia
Bryan Imayanagita
12/2/11
UCI T-RAP
Background
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Protective hypothermia
Reduce ischemic injury to tissue
Invasive and non invasive treatments
Can reduce ischemic brain injuries
Categories of Treatment
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Hypothermia therapy for neonatal
encephalopathy
Cardiac arrest
Stroke
TBI/spinal cord injury
Neurogenic Fever
Mechanism of Protection
by Hypothermia
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Slowing of cellular metabolism (every
1 degree, metabolism slows by 5-7%)
Can act as a neuroprotectant
Oxygen deprivation leads to imbalance
in ion homeostasis (insufficient ATP)
Cell membrane made more
impermeable to prevent flow of ions
Invasive Treatment
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Invasive: cooling catheters
– NS through femoral vein
– Control unit to bring down temperature
(very accurate)
– complications
Bleeding
 Infection
 DVT
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Non Invasive Treatment
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Cold water blanket, torso vest, leg
wraps
Can overshoot or undershoot target
temperature
References
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Diringer, Michael. “Treatment of fever in the neurologic
intensive care unit with a catheter-based heat exchange
system.” Crit Care Med. Vol. 32, No. 2. 2004.
Holzer, Michael. “Mild Hypothermia to Improve the Neurologic
Outcome After Cardiac Arrest.” New England Journal of
Medicine. (2002) Vol. 346, No. 8.
Polderman, Kees H. “Application of therapeutic hypothermia in
the ICU.” Intensive Care Med. (2004) 30:556-575.
Schwab, S. et al. “Moderate Hypothermia in the Treatment of
Patients with Severe Middle Cerebral Artery Infarction.”
American Heart Association. pg. 2461-2466
Simosa, H. et al. “Increased Risk of Deep Venous Thrombosis
with Endovascular Cooling in Patients with Traumatic Head
Injury."