Pharmacology and therapeutic hypothermia

Abstract

Various randomized clinical trials have demonstrated the beneficial effects of therapeutic hypothermia on survival and neurological function following cardiac arrest [1-4]. Despite these well-documented outcomes, a number of physiologic and metabolic complications have been identified [see Chap. 8] [5]. More specifically, data examining the impact of reducing patients' core body temperature to 32-34°C on drug disposition and therapeutic response remains incomplete [6-8]. Given the number of pharmacologic agents provided to patients following cardiac arrest, knowledge of the impact of therapeutic hypothermia on their pharmacokinetic, pharmacodynamic, efficacy and safety parameters is paramount. This chapter includes an in-depth review of both animal and human data as well as provides recommendations for clinical use for pharmacologic agents routinely used in the management of patients undergoing therapeutic hypothermia following cardiac arrest.