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Therapeutic hypothermia in clinical practice Volume 18, issue 4, Avril 2006

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Authors
Institut de Cardiologie, hôpital Pitié-Salpêtrière, 47, boulevard de l’Hôpital, 75013 Paris

Hypothermia is a common consequence of the anaesthetic-induced inhibition of thermoregulatory control during surgical procedures. Involuntary mild hypothermia may lead to several complications increasing peri operative morbidity. Therapeutic hypothermia was developed based on the encouraging results obtained in experimental animal models of ischemic situations. Its transposition to human has been promising with convincing results in cardiac arrest, cerebral ischaemia (cranial traumatism or stroke), and in the acute phase of myocardial infarction. However, as mild hypothermia could have undesirable side effects, complementary prospective and randomized studies are necessary before drawing definitive conclusions. In addition, optimal central temperature targets especially during the initiation phase of cooling and during re-warming need to be clearly specified according to different pathological settings in which the disturbances related to ischaemia-reperfusion prevail.