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VOLUME 19 , ISSUE 9 ( 2015 ) > List of Articles

REVIEW ARTICLE

Targeted temperature management: Current evidence and practices in critical care

Sanjay Kumar, Saurabh Saigal, Jai Sharma, Ritika Dhurwe

Keywords : Critical care, post-cardiac arrest, targeted temperature management, therapeutic hypothermia

Citation Information : Kumar S, Saigal S, Sharma J, Dhurwe R. Targeted temperature management: Current evidence and practices in critical care. Indian J Crit Care Med 2015; 19 (9):537-546.

DOI: 10.4103/0972-5229.164806

License: CC BY-ND 3.0

Published Online: 01-09-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Targeted temperature management (TTM) in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI), meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.


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