Therapeutic Hypothermia After Cardiac Arrest
What is therapeutic hypothermia after cardiac arrest?
Therapeutic hypothermia is a type of treatment to lower the body temperature. This
reduces injury and long-term problems. It’s sometimes used for people who have a cardiac
arrest. Cardiac arrest happens when the heart suddenly stops beating. Once the heart
starts beating again, healthcare providers use cooling devices to lower your body
temperature for a short time. It’s lowered to around 89°F to 96°F (32°C to 36°C).
The treatment usually lasts about 24 hours.
The heart has an electrical signal that helps coordinate the heartbeat. If this signal
is disrupted or abnormal, the heart may not be able to pump the right way. That can
result in cardiac arrest.
Cardiac arrest isn't the same thing as a heart attack. A heart attack happens when
part of the heart doesn’t get enough blood. Sometimes cardiac arrest happens during
or after a heart attack. But it can also happen without one.
During cardiac arrest, blood doesn’t flow to the organs of the body. The brain may
also not get enough blood. That’s why many people don’t recover after cardiac arrest.
The lack of blood flow can cause lasting damage to the brain. The person may be unable
to regain consciousness. Lowering the body temperature right away after cardiac arrest
can reduce damage to the brain. That raises the chances that the person will recover.
Why might I need therapeutic hypothermia after cardiac arrest?
Therapeutic hypothermia can help only some people who have had cardiac arrest. Some
people regain consciousness right after cardiac arrest. These people often don't need
this procedure. It's helpful only for people whose heartbeat returns after a sudden
cardiac arrest. If the heartbeat doesn’t restart soon, it won't help.
Therapeutic hypothermia can be a good choice if the heart restarted but you're still
not responsive. It can raise the chance that you'll wake up.
Experts aren't sure why lowering the body’s temperature reduces brain damage. The
chemical reactions and the metabolism of the tissues of the body slow down. The lowered
temperature may also lessen inflammation in the brain. Both of these factors may help
What are the risks of therapeutic hypothermia after cardiac arrest?
Therapeutic hypothermia is very helpful for some people. But it has some rare risks.
Some of these risks include:
Another abnormal heart rhythm, especially slow heart rates
Severe blood infection (sepsis)
Blood is less able to clot. This can cause bleeding.
Electrolyte and metabolic problems
Raised blood sugar levels
Imbalance of the pH (acid-base) levels in the body
These risks may vary based on your age and other health problems. Ask your healthcare
provider about the risks specific to you.
How do I get ready for therapeutic hypothermia after cardiac arrest?
This procedure is used only for people who are unconscious after cardiac arrest. So
you can’t prepare for it ahead of time.
It can be helpful for family members to learn about the procedure. While your body
temperature is lower, you may look, act, and feel lifeless. You may also have tubes
and monitoring devices attached to you. This can be scary. Your family should know
that the healthcare providers are working hard to give you the best possible chance
What happens during therapeutic hypothermia after cardiac arrest?
Different medical centers may use different methods to do therapeutic hypothermia.
The medical team may start the hypothermia within 4 to 6 hours after the cardiac arrest.
A healthcare provider will give you medicine to help you relax (sedative). It makes
you sleep and keeps you from shivering. You won't remember anything about the procedure
afterward. You may also get another medicine to keep you from moving.
Your heart rate, blood pressure, and other vital signs will be closely watched. Providers
use special thermometers to check your internal temperature.
The provider may use cooling blankets, ice packs, or cooling pads to bring the body
temperature down. The goal is to cool as quickly as possible.
Another cooling choice is internal cooling. 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 warmer temperatures. In some cases, they may also use rewarming devices.
Sometimes, providers may do therapeutic hypothermia at the same time as other treatments.
For example, they might do a heart catheterization after a cardiac arrest caused by
a heart attack.
What happens after therapeutic hypothermia after cardiac arrest?
The medical team will carefully watch you. You'll be in the intensive care unit (ICU).
You may be on a ventilator to help with breathing. You may have various lines and
tubes to support body functions.
People don't always respond right away to the procedure. It may take a couple of days.
Providers often wait at least 3 days after the procedure to see how the cardiac arrest
affected the brain. The procedure doesn't guarantee that you'll regain brain function.
Tests for brain function may be done to see how your brain has recovered. These may
include an electroencephalogram (EEG) or a computed tomography (CT) scan of the brain.
Some people do eventually wake up after therapeutic hypothermia. They may not have
any lasting brain injury. Others might have some problems with thinking. They'll need
therapy. Sometimes cardiac arrest may harm other organs, like the kidneys. You'll
need follow-up care.
Medical care will depend on the reason for the cardiac arrest and the degree of damage.
Other health problems you have will also determine the care you need. You may need
medicine, procedures, and physical therapy. Some people might need surgery for heart
disease. Other people might need an automatic defibrillator. Almost everyone will
need to stay in the hospital for a while. Talk with your provider about what to expect
after the procedure.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you're having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you're to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you didn't have the test or procedure
Any alternative tests or procedures to think about
When and how you'll get the results
Who to call after the test or procedure if you have questions or problems
How much you'll have to pay for the test or procedure