Role of hypothermia in hemorrhagic shock

Abstract

Hemorrhagic shock that leads to cardiovascular collapse does not respond well to conventional methods of cardiopulmonary resuscitation. Even when the source of bleeding can be controlled and the circulation restored, cerebral ischemia lasting for >5 min invariably results in severe brain damage. Often the underlying injuries are reparable but the patient dies of irreversible shock. In this setting, strategies to maintain cerebral and cardiac viability long enough to gain control of hemorrhage and restore intravascular volume could be life-saving. This requires an entirely new approach to the problem, with emphasis on rapid total body preservation, repair of injuries during metabolic arrest, and controlled resuscitation, so-called emergency preservation and resuscitation. Currently, hypothermia is the most effective method for preserving cellular viability during prolonged periods of ischemia. Herein, the authors describe the rationale behind the development of this strategy, its impact on various cellular...