Complicações da hipotermia terapêutica pós-parada cardiorrespiratória

Abstract

After the occurrence a Cardiopulmonary Arrest (CPR) the brain may present severe lesions which significantly elevate the mortality rate. The American Heart Association (AHA) recommends therapeutic hypothermia (TH) for neurological protection. This procedure consists in reducing the central temperature of patients that suffered from CPR, however, in Brazil, such treatment is not put in practice even thought it´s recommended. Due to this occurrence, concerns were raised regarding the possible complications when applying this procedure. This case study has the goal to identify the possible complications in unconscious patients after a Cardiopulmonary Arrest, who were treated with therapeutic hypothermia. This paper consists of an integrative literature review along with a descriptive approach. The main identified complications were infections, tremors, convulsions, pulmonary edemas, rebound hyperthermia, metabolic and electrolyte disturbances, hemorrhaging and arrhythmia. Some authors describe the arrhythmia as a complication related to the treatment due to electrolyte alterations or a previously existing heart condition. The infections are related to the long permanency of an endotracheal tube, intravascular catheters and a long stay in an Intensive Care Unit. Hemorrhaging is usually related to invasive procedures. The complications related to the therapy were tremors, convulsions, arrhythmias, pulmonary edemas, electrolyte disturbances, and rebound hyperthermia. The goal of this case study was reached; however, new studies that identify complications during TH must be done, so that important preventive actions can be recommended so as to guarantee the effectiveness of therapeutic hypothermia, subsequently, improving the care quality and prognosis of critical patients.