Therapeutic hypothermia

Hypothermia is common during anaesthesia and surgery owing to anaesthetic-induced inhibition of thermoregulatory control. Perioperative hypothermia is associated with numerous complications. However, for certain patient populations, and under specific clinical conditions, hypothermia can provide substantial benefits. Lowering core temperature to 32–34 °C may reduce cell injury by suppressing excitotoxins and oxygen radicals, stabilizing cell membranes, and reducing the number of abnormal electrical depolarizations. Evidence from animal studies indicates that even mild hypothermia provides substantial protection against cerebral ischaemia and myocardial infarction. Mild hypothermia has been shown to improve outcome after cardiac arrest in humans. Randomized trials are in progress to evaluate the potential benefits of mild hypothermia during aneurysm clipping and after stroke or acute myocardial infraction. However, as hypothermia can cause unwanted side-effects, further research is needed to better quantify the risks and benefits of therapeutic hypothermia.