Cooling Strategies Outside the Central Nervous System

摘要

Therapeutic hypothermia and temperature management strategies are used today in a wide variety of clinical conditions. Dr. Joseph Varon, University of Texas Health Science Center in Houston, discussed the use of therapeutic hypothermia in the management of acute respiratory distress syndrome (ARDS) and sepsis. ARDS is a severe life-threatening medical condition characterized by widespread inflammation in the lungs. Dr. Varon provided an update of the use of therapeutic hypothermia in patients to provide adequate oxidation and oxygen delivery. He then discussed the use of hypothermia in the treatment of sepsis, touching primarily on the effects of temperature on inflammatory and immune functions. In another presentation, Dr. Markus Foedisch, Intensive Care in Emergency Medicine, Waldkrankenhaus Bonn-Bad Godesberg, lectured on managing heat stroke and malignant hyperihermia with targeted temperature management protocols. Dr. Foedisch emphasized the therapeutic objectives of managing heat stroke, including immediate cooling and aggressive support of oxygen-based function. Finally, Dr. Samuel Tisherman, University of Maryland, provided an update on the importance of the rewarming phase in the treatment ofpoly trauma. Because many patients get cold after severe trauma, it is important that established rewarming approaches are developed and tested that will both promote neuroprotection as well as produce no detrimental effects on multiorgan functions associated with polytrauma. Experimentally, induction of deep hypothermia may buy time for hemorrhage control in patients who have exsanguinated. The complexity of these new approaches was also emphasized as well as the importance of adequate training for the team members.