Out of hospital cardiac arrest (OHCA) occurs approximately 2500 times yearly in Norway. One study done at Oslo University Hospital showed that return of spontaneous circulation (ROSC) occurred in 36 % of the cases, and the majority of patients were admitted to the ICU for additional treatment and monitoring. Therapeutic hypothermia is one of the most important aspects in the treatment of comatose patients post cardiac arrest. A lot is known about the neuroprotective properties of hypothermia in the treatment of post cardiac arrest syndrome. There is however, a paucity of knowledge, when it comes to its effects on the cardiovascular system. This is especially true for the hemodynamically unstable patients, where this treatment option traditionally has been contraindicated. We therefore decided to search the available literature, to see if any new knowledge has been gathered on therapeutic hypothermia’s effects on the heart as well as the vascular system as a whole.
A systematic search was performed in Pubmed, Cochrane Library, UpToDate and McMaster Plus. The initial search found 430 publications. Of these, 13 relevant studies were gathered and analysed.
Although there is still too little information for a conclusion to be drawn, most of the included studies have shown that therapeutic hypothermia seems to have no more deleterious effects on the hemodynamically unstable patients compared with patient groups at low risk. In fact, therapeutic hypothermia may have additional cardioprotective properties, possibly making it a viable option in the treatment of cardiogenic shock. Additional research is needed.