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Induced Therapeutic Hypothermia After Cardiac Arrest
Pages 7 (1757 words)
Therapeutic hypothermia is also known as ‘targeted temperature management’. Michelle E. has discussed in detail about the induction of therapeutic hypothermia and its outcomes in patients undergoing open cardiac surgery. …
TDuring an open heart surgery, there is significant risk of neurological injury on account of the lack of oxygen supply to brain as the circulation comes to a halt. In the absence of oxygen, the brain undergoes anaerobic metabolism as reported by Michelle E. (2011). This leads to damage to ATP dependent cellular functions with a resulting increase in calcium and glutamate excretion. The brain cells thus become more active, consuming more oxygen. With the increasing hypoxemia, further damage occurs leading to cell death. The resultant cerebral edema further enhances the damage. Also, as a result of all these processes, the blood-brain barrier also becomes ineffective further contributing to cerebral edema. As soon as the circulation returns after the heart starts pumping again, reperfusion injury occurs which adds up to the ongoing damage. Meanwhile, there is already an onset of the inflammatory reaction as a result of cell death leading to a release of neutrophils and macrophages in an attempt to remove the cellular debris. The resultant production of free radicals also catalyses the damaging process thus worsening the cerebral edema. This vicious cycle continues leading to brain death.
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