Complications of Therapeutic Hypothermia Following Cardiac Arrest

  • Edgar Argulian
  • Renata Barbosa
  • Janet Shapiro
  • Eyal Herzog


Randomized clinical trials and observational studies have shown that therapeutic hypothermia improves neurologic outcomes and survival in patients following cardiac arrest [1–3]. As the benefit is impressive, with the number needed to treat as low as six patients, therapeutic hypothermia should be applied to more and more patients [4]. At the same time, therapeutic hypothermia is a complex and expensive therapy requiring appropriate equipment, trained personnel, and close patient monitoring. A systematic approach to coordinate care at multiple levels is required for proper patient selection, effective implementation of therapy, and monitoring for possible complications. In our institution, we use a unified pathway-based approach to therapeutic hypothermia [5]. The pathway outlines patient management in a stepwise manner: from the field through the emergency department into the cardiac catheterization laboratory and to the critical care unit (step 1); induced invasive hypothermia protocol in the critical care unit (step 2); and management following the re-warming phase including decisions for future care based on neurologic outcome (step 3). Figure 8.1 shows the pathway for the management of the survivors of out-of-hospital cardiac arrest as implemented at St Luke’s Roosevelt Hospital Center, New York. The current chapter focuses on recognition and management of potential complications of hypothermia.


Cardiac Arrest Neurologic Outcome Therapeutic Hypothermia Critical Care Unit Mild Therapeutic Hypothermia 
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Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  • Edgar Argulian
    • 1
  • Renata Barbosa
    • 1
  • Janet Shapiro
    • 1
  • Eyal Herzog
    • 1
  1. 1.Department of MedicineSt. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and SurgeonsNew YorkUSA

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