TY - JOUR
T1 - Postcardiac arrest temperature management
T2 - Infectious risks
AU - Kuchena, Admire
AU - Merkel, Matthias J.
AU - Hutchens, Michael P.
N1 - Publisher Copyright:
© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - Purpose of review: Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery. Coupled with neurological benefit, multiple complications including infection have been associated with therapeutic hypothermia following out-of-hospital cardiac arrest. In this review, we will discuss therapeutic hypothermia, and more broadly, temperature management, as a risk for ICU infection. Recent findings: The application of therapeutic hypothermia following out-of-hospital cardiac arrest has been associated with infectious complications. Studies of hypothermic animal models have provided useful insights into mechanisms by which therapeutic hypothermia confers neuroprotection. Ironically, the same mechanisms through which therapeutic hypothermia provides neuroprotection have been implicated in the risk of infection associated with therapeutic hypothermia. Studies have demonstrated types of infections, pathogens, and the impact of infections on mortality and neurological recovery. Summary: Studies demonstrate increased rate of pneumonia and bacteremia but decreased rate of other infections, suggesting redistribution but no overall increased risk of infection per se. The diagnosis of infection during therapeutic hypothermia does not impact mortality or neurological recovery.
AB - Purpose of review: Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery. Coupled with neurological benefit, multiple complications including infection have been associated with therapeutic hypothermia following out-of-hospital cardiac arrest. In this review, we will discuss therapeutic hypothermia, and more broadly, temperature management, as a risk for ICU infection. Recent findings: The application of therapeutic hypothermia following out-of-hospital cardiac arrest has been associated with infectious complications. Studies of hypothermic animal models have provided useful insights into mechanisms by which therapeutic hypothermia confers neuroprotection. Ironically, the same mechanisms through which therapeutic hypothermia provides neuroprotection have been implicated in the risk of infection associated with therapeutic hypothermia. Studies have demonstrated types of infections, pathogens, and the impact of infections on mortality and neurological recovery. Summary: Studies demonstrate increased rate of pneumonia and bacteremia but decreased rate of other infections, suggesting redistribution but no overall increased risk of infection per se. The diagnosis of infection during therapeutic hypothermia does not impact mortality or neurological recovery.
KW - Cardiac arrest
KW - Central venous catheter-associated bloodstream infection
KW - Infection
KW - Pneumonia
KW - Therapeutic hypothermia
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U2 - 10.1097/MCC.0000000000000125
DO - 10.1097/MCC.0000000000000125
M3 - Review article
C2 - 25010460
AN - SCOPUS:84925943542
SN - 1070-5295
VL - 20
SP - 507
EP - 515
JO - Current Opinion in Critical Care
JF - Current Opinion in Critical Care
IS - 5
ER -