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Journal Article

Citation

Feeney JM, Loiacono LA, Shapiro D. Conn. Med. 2013; 77(6): 347-351.

Affiliation

Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, University of Connecticut School of Medicine, Farmington, USA. jfeeney@stfranciscare.org

Copyright

(Copyright © 2013, Connecticut State Medical Society)

DOI

unavailable

PMID

23923253

Abstract

BACKGROUND: Mild therapeutic hypothermia (MTH) due to anoxic brain injury after cardiac arrest has been well studied, and is widely accepted as useful in the treatment of anoxic brain injury after cardiac arrest. However, MTH as treatment for other causes of anoxia, including ischemic stroke, traumatic braininjury, drowning, andcardiac arrest due to trauma, is still controversial. METHODS: We reviewed the records of three consecutive patients admitted to the surgical intensive care unit with cardiac arrest after hanging. All three patients were placed on the institution's MHT protocol. Eligibility criteria for our institutional protocol include that the patient be postcardiac arrest, with return of spontaneous circulation to a systolic blood pressure of >90 for at least 30 minutes, and an elapsed time of less than eight hours from return of spontaneous circulation. RESULTS: One of our small series of three patients survived to a normal neurologic outcome (33.3%). We discuss the risks and benefits of MTH for treatment of anoxia, with an emphasis on causes other than cardiac arrest. We reviewed the literature supporting MTH in various causes, andreported on the potential physiologic benefits of MTH for anoxic brain injury. CONCLUSION : Although there is sparse literature about MTH in treatments other than for out-of-hospital cardiac arrest, understanding of the purported mechanisms, and a review of case reports and case series suggests its possible utility in the treatment of less frequently encountered injuries, such as anoxia due to hanging. Further studies are needed to fully understand the utility and full potential of this emerging treatment modality.


Language: en

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