Postcardiac arrest temperature management: Infectious risks

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)507-515
Number of pages9
JournalCurrent Opinion in Critical Care
Volume20
Issue number5
DOIs
StatePublished - Jan 1 2014

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Keywords

  • Cardiac arrest
  • Central venous catheter-associated bloodstream infection
  • Infection
  • Pneumonia
  • Therapeutic hypothermia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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