Application of hypothermia treatment methods
1. What is hypothermia technique?
Decreased body temperature is a way to help reduce anaerobic metabolism in cells, reduce oxygen and energy requirements of tissues, reduce calcium entering cells and reduce free radical production, blood-brain barrier damage, from As a result, the brain reduces inflammation and cerebral perfusion, improves oxygen supply, reduces brain cytotoxicity and recovers very well. In fact, this method has been routinely implemented in the world, but it is still limited in Vietnam.
2. Indications for hypothermia treatment
Protecting nerve cells in comatose patients after respiratory arrest; Patients in circulatory arrest present with pulseless ventricular fibrillation-tachycardia during cardiopulmonary resuscitation; Postcardiac arrest comatose patients present with asystole - pulseless electrical activity during CPR; Finally, the patient has persistent raised intracranial pressure and does not respond to medical treatment. Contraindications of the method include:
Patients with severe and prolonged hemodynamic disorders; Patients with severe infections; Patients with coagulopathy, prolonged bleeding; The patient has hematological problems that are aggravated by hypothermia.
3. Methods of hypothermia
4. Stages of hypothermia
Stage 1: Rapid hypothermia, by the method selected above, the body temperature quickly reaches 32-36°C in 1-3 hours; Stage 2: Maintain desired body temperature and, depending on the patient's condition as well as the strategy of each resuscitation center, maintain the condition for 24-48 hours; Stage 3: The rewarming phase with an increase of body temperature from 0.25-0.5°C per hour to avoid complications of acute pulmonary edema or hemodynamic disturbances; Stage 4: Maintain a normal body temperature for a period of 24 hours. The technique of hypothermia is an advanced technique and has been proven in many parts of the world to be effective in patients with circulatory arrest. Therefore, this technique needs to be replicated in Vietnam to provide the best treatment results for critically ill patients with respiratory arrest when other measures are meaningless.
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