Guidelines For Clinical Practice
Copyright ©2012 Baishideng. All rights reserved.
World J Crit Care Med. Aug 4, 2012; 1(4): 106-122
Published online Aug 4, 2012. doi: 10.5492/wjccm.v1.i4.106
Use of hypothermia in the intensive care unit
Jesse J Corry
Jesse J Corry, Department of Neurology, Marshfield Clinic, Marshfield, WI 54449-5777, United States
Author contributions: Corry JJ wrote and reviewed the article.
Correspondence to: Jesse J Corry, MD, Department of Neurology, Marshfield Clinic 4F3, 1000 North Oak Avenue, Marshfield, WI 54449-5777, United States. corry.jesse@marshfieldclinic.org
Telephone: +1-715-3875350 Fax: +1-715-3879184
Received: February 14, 2012
Revised: June 25, 2012
Accepted: July 12, 2012
Published online: August 4, 2012
Abstract

Used for over 3600 years, hypothermia, or targeted temperature management (TTM), remains an ill defined medical therapy. Currently, the strongest evidence for TTM in adults are for out-of-hospital ventricular tachycardia/ventricular fibrillation cardiac arrest, intracerebral pressure control, and normothermia in the neurocritical care population. Even in these disease processes, a number of questions exist. Data on disease specific therapeutic markers, therapeutic depth and duration, and prognostication are limited. Despite ample experimental data, clinical evidence for stroke, refractory status epilepticus, hepatic encephalopathy, and intensive care unit is only at the safety and proof-of-concept stage. This review explores the deleterious nature of fever, the theoretical role of TTM in the critically ill, and summarizes the clinical evidence for TTM in adults.

Keywords: Targeted temperature management; Therapeutic hypothermia; Cardiac arrest; Normothermia; Intracerebral pressure; Critical care