Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2013
Review Meta Analysis[Pathophysiology and management of post-cardiac arrest syndrome.]
This review aims at providing an update on post-cardiac arrest syndrome, from pathophysiology to treatment. ⋯ If ongoing evaluations should shed light on potential efficiency of new therapeutic drugs, a multidisciplinary approach of the post-cardiac arrest syndrome in expertise centre is essential.
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Therapeutic hypothermia (TH) is considered a standard of care in the post-resuscitation phase of cardiac arrest. In experimental models of traumatic brain injury (TBI), TH was found to have neuroprotective properties. However, TH failed to demonstrate beneficial effects on neurological outcome in patients with TBI. ⋯ The control of the rewarming phase is crucial to avoid temperature overshooting and should not exceed 1°C/day. Besides its use in the management of intracranial hypertension, therapeutic cooling is also essential to treat hyperthermia in brain-injured patients. In this review, we will discuss the benefit-risk balance and practical aspects of therapeutic temperature management in TBI patients.