Untoward Effects in the Practice of Therapeutic Hypothermia: A Literature Update

Abstract

Out-of-hospital cardiac arrests (OHCA) is the plague of the modern day and therapeutic hypothermia (TH) is launched to be a remedy against this. TH is practised mainly in the treatment of adult cardiac arrest and neonatal hypoxic-ischemic encephalopathy. Despite the improved benefits of mild TH, there are commonly overlooked complications associated during management. TH may cause an increase in insulin resistance and a reduction in insulin levels which result in hyperglycemia. Studies showed a significantly increased incidence of meningitis, pneumonia and wound infections. Hypothermia was also reportedly associated with increased blood loss and transfusions. In addition, electrolyte abnormalities such as hypokalaemia, hypomagnesaemia, hypophosphatemia, hypo- and hyperglycaemia have been described during TH. The procedure has also been shown to incite mild metabolic acidosis. This article reviews the current literature to provide systematic data regarding adverse and untoward effects attributed to the procedure of TH in the emergency setting.