Episode #4: Early Induction of Temperature Management
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The Podcast entitled “Early Induction of Temperature Management” with Dr. Wilhelm Behringer, Professor and Chair, Department of Emergency Medicine, University Hospital Vienna discussed several topics related to the use of TH in cardiac arrest patients. Dr. Behringer first talked about his systemic review of cardiac arrest animal studies that reported a consistent favorable effect of TTM versus normothermia. Next a recent Letter to the Editor submitted by Dr. Behringer and colleagues reviewed the results of a recent meta-analysis by Granfeldt and colleagues in Resuscitation. The letter emphasized 2 limitations from that analysis including the approach of splitting the evaluations at 2 different outcome assessments and the inclusion of a specific study that increased the clinical heterogeneity of the analyzed data sets. This issue of patient heterogeneity led to an interesting discussion on how best to possibly stratify the patient populations to temperature dose and the fact that “one size fits all” is not appropriate when treating these patients. Finally, the importance of early cooling and the possible advantages of initiating cooling earlier and continuing the cooling treatment with a feedback cooling system to ensure consistent levels of hypothermia were emphasized.
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