What is an optimal temperature during therapeutic hypothermia?

In most centers, the patient is actively cooled by using an induced hypothermia protocol for 24 hours to a goal temperature of 32ºC-36ºC. The goal is to achieve the target temperature as quickly as possible. In most cases, this can be achieved within 3-4 hours of initiating cooling.

What happens during therapeutic hypothermia?

That’s when chilled fluids are given through an IV (intravenous) line into your bloodstream. The therapeutic hypothermia will likely last around 24 hours. The medical team will slowly rewarm you over several hours. They may set cooling blankets at gradually higher temperatures.

What is the characteristic ECG findings on patients with hypothermia?

The ECG findings of hypothermia include: An “Osborne wave” characterized by a notch in the downward portion of the R wave in the QRS complex. Low voltage. Bradycardia: This can be sinus bradycardia, junctional bradycardia, atrial fibrillation with a slow ventricular response or higher grade AV blocks.

How do you monitor temperature during therapeutic hypothermia?

Patient Monitoring and Management: Monitor and document vital signs every 15 minutes X4, every 30 minutes X2, then every 1 hour with the exception of patient temperature, which will continue every 15 minutes until reaching target temperature of 33°C.

What are the inclusion criteria for therapeutic hypothermia?

Therapeutic Hypothermia (TH) shall be initiated on all adult cardiac arrest patients with return of spontaneous circulation (ROSC) that fit the inclusion criteria, and does not have any of the following: eye opening to painful stimuli, pre-existing coma, traumatic arrest (either penetrating or blunt), body temperature …

When should TTM be started?

TTM should be induced and maintained at the selected target temperature for 24 hours, and rewarmed gradually at a rate not faster than 0.5°C per hour. Every hour of delay in TTM after ROSC increases mortality by 20%. Thus, TTM should be initiated as soon as possible after ROSC.

What are the indications for therapeutic hypothermia?

Does hypothermia prolong QT?

Accidental hypothermia is itself known to cause prolongation of the corrected QT interval (QTc). QTc prolongation can cause polymorphic VT and VF. If this also occurs in TH, it may induce refibrillation.

What kind of ECG abnormality occurs below 34 C hypothermic condition?

J waves (also called Osborne waves) are pathognomonic for hypothermia when present.

When do you start TTM?

Thus, TTM should be initiated as soon as possible after ROSC. While there is low-quality evidence regarding the duration of cooling, most studies have suggested that rewarming should begin 24 hours after the patient has reached the target temperature.

Which condition is a contraindication to therapeutic hypothermia during the post?

Contraindications. There are few true contraindications for TH. Medical conditions in which the risk may be excessive include documented intracranial hemorrhage, severe hemorrhage leading to exsanguination, hypotension refractory to multiple vasopressors, severe sepsis, and pregnancy.