Publication: El manejo de la hipotermia terapéutica tras una parada cardiaca extrahospitalaria
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2020-05-15
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Abstract
Introducción: la parada cardiaca extrahospitalaria (PCEH) tiene un alto porcentaje de mortalidad y donde gran parte de los supervivientes presentan graves secuelas neurológicas. Desde 2002 existen estudios que avalan que la hipotermia terapéutica (HT) es una de las formas de combatir dicho daño neurológico. Por ello, el objetivo principal de este trabajo es conocer la evidencia científica y efectividad existente sobre el manejo de la HT.
Metodología: se realizó una revisión bibliográfica en 4 bases de datos correspondientes al período entre 2016-2020. Se obtuvieron 15 artículos utilizando como sujeto de estudio: personas mayores de 18 años que hayan sobrevivido a una parada cardiaca extrahospitalaria.
Resultados y discusión: se describe y compara la información más significativa de los 15 artículos, de manera que la HT mejora los resultados neurológicos y de supervivencia. La HT, actualmente, se trata de conseguir una temperatura objetivo de 32-36ºC manteniéndola durante 24h y tras ello, se enfría a una velocidad de 0,25-0,5ºC/ h hasta conseguir la normotermia. Para conseguir dicha temperatura objetivo, se utilizan diferentes métodos de calentamiento, intravasculares y/o superficiales.
Conclusiones: Está demostrado que la HT tiene beneficios frente a la normotermia debido a su efecto neuroprotector tras una parada cardiaca a pesar de que pueden surgir diversas complicaciones de la misma.
Introduction: out-of-hospital cardiac arrest (PCEH) has a high percentage of mortality and where a large part of the survivors presents neurological effects. Since 2002 there are studies which support therapeutic hypothermia is one of the ways to combat neurological damage. Therefore, the main objective of this work is to know the scientific evidence and the existing effectiveness in the management of therapeutic hypothermia (HT). Methodology: a bibliographic review was performed in 4 databases from 2016 to 2020. 15 articles were obtained using as study subject: people over 18 who survived an out-of-hospital cardiac arrest. Results and discussion: the most significant information from the 15 articles is described and compared, so that HT improves neurological and survival results. HT is currently trying to achieve an objective temperature of 32-36ºC by maintaining it for 24 hours and after that, it cools at a rate of 0.25-0.5ºC / h until normothermia is achieved. To achieve the target temperature, different heating methods, intravascular and / or superficial, are used. Conclusions: It is proved that HT has benefits over normothermia due to its neuroprotective effect after cardiac arrest despite the fact that various complications might rise up from it.
Introduction: out-of-hospital cardiac arrest (PCEH) has a high percentage of mortality and where a large part of the survivors presents neurological effects. Since 2002 there are studies which support therapeutic hypothermia is one of the ways to combat neurological damage. Therefore, the main objective of this work is to know the scientific evidence and the existing effectiveness in the management of therapeutic hypothermia (HT). Methodology: a bibliographic review was performed in 4 databases from 2016 to 2020. 15 articles were obtained using as study subject: people over 18 who survived an out-of-hospital cardiac arrest. Results and discussion: the most significant information from the 15 articles is described and compared, so that HT improves neurological and survival results. HT is currently trying to achieve an objective temperature of 32-36ºC by maintaining it for 24 hours and after that, it cools at a rate of 0.25-0.5ºC / h until normothermia is achieved. To achieve the target temperature, different heating methods, intravascular and / or superficial, are used. Conclusions: It is proved that HT has benefits over normothermia due to its neuroprotective effect after cardiac arrest despite the fact that various complications might rise up from it.