Nursing Made Incredibly Easy!
February 2013, Volume 11 Number 1 , p 47 - 50
Therapeutic hypothermia (TH) is the intentional reduction of a patient's core body temperature to reduce the likelihood of permanent damage to the brain and heart. Hypothermia decreases the body's demand for oxygen by slowing the cellular metabolic activity of the heart, brain, and other vital organs. Reduced metabolic activity can prevent destructive chemical reactions, such as free radical production, calcium shifts, and excitatory amino acid release, from occurring within cells.Hypothermic treatments are potentially beneficial in the following situations: * traumatic brain injuries * neurogenic fever * cerebral vascular accident * postcardiac arrest care * spinal cord injuries * heart surgery * neonatal encephalopathy * preservation of donated organs * hepatic encephalopathy * subarachnoid hemorrhage.The goal of TH is to reduce the core body temperature to 89.6[degrees] F to 93.2[degrees] F (32[degrees] C to 34[degrees] C) within 6 hours of the initial injury or event for 24 to 48 hours. Patients selected for TH are critically ill and should be quickly transferred to an ICU because the process to induce and maintain TH is labor intensive, requiring continuous monitoring to provide the patient with optimal neurologic and cardiovascular outcomes.TH can be achieved by several methods, such as: * ice packs * cooling blanket * chilled I.V. fluid * central venous cooling catheter (CVCC) * peritoneal dialysis cooling (PDC) * gastric lavage * neonatal cooling caps * transnasal evaporative cooling device (TECD) * extracorporeal membrane oxygenation (ECMO) * cardiac bypass machine * hypothermic perfusion machine.Ice packs, enclosed leak-proof packets filled with ice or cooled gel applied to strategic sites that emit body heat (such as the axilla, head, and groin), are labor intensive when used for TH, requiring the nurse to replace the cold packs hourly until the patient's core temperature reaches the desired goal. Place a barrier, such as a cloth or disposable pad, between