Cooling and cathing the post-resuscitated.docVIP

Kern Critical Care 2011,15:178 /content/15/4/178 COMMENTARY ‘Cooling and cathing’ the post-resuscitated Karl B Kern* See related research by Cronier et al., /content/15/3/R122 patients, therapeutic hypothermia was not performed Abstract because of severe hemodynamic instability or moribund status. Target temperature (32 to 34°C) was reached in Cronier and co-workers provide additional evidence that routine use of mild therapeutic hypothermia combined with emergent coronary angiography and percutaneous intervention results in excellent survival with intact neurological function for post-resuscitation patients with ventricular ?brillation. 81% of patients ese proportions of patients receiving hypothermia and reaching temperature goal compare favorably with other reports [4]. ough all patients were considered for coronary angiography regardless of their electrocardiographic ? ndings, those considered ‘hemodynamically unstable (blood pressure 90 mmHg with or without epinephrine Determining priorities for optimal post-resuscitation for 30 minutes or more) were not ese unstable patients might be those most in need of urgent coronary angio- graphy post-cardiac arrest e ‘sickest’ patients are often care is challenging. Cronier and colleagues [1] share their experience with combining routine coronary angiography with induction of mild hypothermia for patients success- fully resuscitated from cardiac arrest. Most recognize the value of therapeutic hypothermia in the treatment of the the ones with the most to gain by an aggressive approach. Unfortunately, by their exclusion no data were obtained in this ‘unstable’ group. However, their data evaluating post-cardiac arrest patient [2,3]. But other suggested the use of early coronary angiography with or without therapies have limited e? cacy data, leaving both the PCI in post-cardiac arrest patie