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Therapeutic Hypothermia for Cardiopulmonary Arrest in the Pediatric Patient - Research Paper Example

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Abstract The application of therapeutic hypothermia in cardiac arrest has been applied in children and adults. In pediatric cases, it has been applied in cardiac arrest as well as neonates with birth asphyxia. Therapeutic hypothermia involves the cooling of a comatose patient to a core body temperature of 32-34oC for a period of 12-24 hours (Elizabeth et al 300)…
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Therapeutic Hypothermia for Cardiopulmonary Arrest in the Pediatric Patient

Download file to see previous pages... The paper also adds on the patient suitable for this treatment modality. The paper also seeks to dwell on the mechanistic of therapeutic hypothermia. This is in terms of methods employed to induce hypothermia. It also explores the various methods that can be used to monitor temperature. Recommendations are suggested in the end. This is in the hope that the recommendations will help the clinician in issuing treatment to pediatric cardiac arrest cases using therapeutic hypothermia. 1.0 Introduction In the Northern America, the incidence of cardiac arrest in both adults and children ranges from 0.53 to 0.91 for every 1,000 persons. Out of these, about 8% survive (Polderman et al. 1100). The deaths have been attributed to the devastating neurological cell damage associated with cardiac arrest. In pediatric cases, the 1 year survival rate is poor despite the relative success in the initial resuscitation. A randomized controlled trial done on cardiac arrest patients revealed that the survival rate from an out of hospital cardiac arrest was at 2-28% compared to 14-42% in an in hospital cardiac arrest (Polderman et al. 1100). This is because mortality and morbidity is dependent on the duration of the arrest. The topic was chosen so as to enlighten those working in the pediatric department about the application of therapeutic hypothermia following pediatric cardiac arrest. Therapeutic hypothermia in cardiology was first used in 1950 for cardiac surgery to protect the brain from hypoxia. The survival outcomes of this procedure in cardiac patients resulted in subsequent studies and trials. A study done in 2000 in Europe demonstrated that patients treated at these temperatures had a better outcome than those managed in the normal temperatures (Pozos et al 376). In 2003, the ILCR approved the use of therapeutic hypothermia for the management of patients who developed neurological injury as a complication of cardiac arrest even after successful resuscitation (Polderman et al. 1115). This has significantly contributed to the development of various devices used in the procedure so as to reduce the complication cases. In neonate, following cardiac arrest, Hypoxic Ischemic Encephalopathy (HIE) is the most serious complication. The extent of this complication is dependent on the duration of hypoxia and the effectiveness of the emergency resuscitation. Therapeutic hypothermia involves the cooling of a comatosed patient to a core body temperature of 32-34oC for a period of 12-24 hours (Elizabeth et al 300). According to the American Association Guidelines, the procedure should only be done if the patient remains in a coma state following the return of spontaneous circulation. This means that the procedure can only be done if the child does not recover fully from the cardiac arrest even after a successful resuscitation. Therapeutic hypothermia has been applied for both pediatric and adult cases of stroke, acute encephalitis, near drowning patients and neonatal hypoxemia. In the recent years, it has been applied in the treatment of increased intracranial pressure and traumatic brain injury. However, the benefit of this method in traumatic brain injury in pediatric cases has not yet been established. The main goal of this treatment modality is to preserve the brain function. This has been attributed to success in reducing the mortality and morbidity associated with cardiac arrest. T ...Download file to see next pagesRead More
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