Post-cardiac arrest management has undergone substantial revisions within the past several years, particularly with regards to temperature management. This remains an area of active controversy and investigation, with the TTM-2 trial currently underway. Although equipoise still exists, this chapter describes a streamlined 36C approach which is based on evidence, guidelines, and experience with various strategies.
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The IBCC chapter is located here.
- The podcast & comments are below.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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Great tips on shivering control!
I would recommend skin counter warming as a first line defense for shivering. Not only gloves and socks but a bair hugger works great!
What would you recommend as a go to device for cooling?
I’m cooling for something portable, reliable to get to 36 and hold them there and, preferably, not too expensive.
Concerning your comments re: normocapnia….
– we all see many post-arrest patients with a metabolic acidosis for various reasons
– if we target normocapnia, are you not preventing the necessary respiratory compensation?
– how have you dealt with this?
What is the utility of ordering a lactic acid post-cardiac arrest?