BACKGROUND: cardiac arrest is one of the main causes of death in the world and its impact on the population still remains very significant due to the sequelae, and in particular the neurological ones, reported by patients following a lack of oxygen in the brain. For this reason, greater importance is now placed on post resuscitation assistance and therefore on assistance in the post cardiac arrest phase. PURPOSE AND OBJECTIVES: this literature review has as its main purpose to demonstrate the clinical efficacy of therapeutic hypothermia, the objectives instead are to analyze the pros and cons of using this clinical practice, considering the evolution of the methodologies used and the knowledge now available METHODOLOGY: Systematic literature review was chosen as the modality. The information was taken from secondary online and paper sources for the background topics while the results were searched in the following online databases: Google Scholar, Cinahl, Cochrane and Pubmed using the Boolean operators AND and OR in the various strings of Research. At the end I analyzed, as eligible for the pre-established inclusion criteria, 18 articles to elaborate the results of the thesis. RESULTS: Eighteen articles were selected and considered, including two observational studies, four meta-analyzes, five systematic literature reviews and seven RCTs. CONCLUSIONS: from the analysis of these articles it emerges that the practice of induced therapeutic hypothermia does not lead to better neurological outcomes in patients who have undergone this practice than in those who have not been included, nor does it significantly improve the quality of life of these people it is also necessary to consider that the induction of therapeutic hypothermia presents adverse events that could worsen the initial clinical picture. KEYWORDS IN ITALIAN: cardiac arrest, neurological damage, therapeutic hypothermia, neuroprotection, outcomes. KEYWORDS: cardiac arrest, neurological damage, therapeutic hypothermia, neuroprotection, outcome
BACKGROUND: l’arresto cardiaco rappresenta una delle principali cause di morte nel mondo e il suo impatto sulla popolazione rimane ancora molto rilevante a causa delle sequele, ed in particolare quelle neurologiche, riportate dai pazienti a seguito della carenza di ossigeno a livello cerebrale. Per questo motivo oggi si pone maggiore importanza all’ assistenza post rianimatoria e quindi all’assistenza nella fase post arresto cardiaco. SCOPO ED OBIETTIVI: questa revisione della letteratura ha come scopo principale quello di dimostrare l’efficacia clinica dell’ipotermia terapeutica, gli obiettivi invece sono quelli di analizzare i pro e i contro dell’utilizzo di questa pratica clinica, considerando l’evoluzione delle metodologie utilizzate e le conoscenze ora disponibili METODOLOGIA: È stata scelta come modalità la revisione sistematica della letteratura. Le informazioni sono state prese da fonti secondarie online e cartacee per gli argomenti di background mentre per i risultati è stata fatta una ricerca nelle seguenti banche dati online: Google Scholar, Cinahl, Cochrane e Pubmed usando gli operatori booleani AND e OR nelle varie stringhe di ricerca. Al termine ho analizzato, in quanto eleggibili per i criteri di inclusione prefissati, 18 articoli per elaborare i risultati della tesi. RISULTATI: Sono stati selezionati e presi in considerazione diciotto articoli, di cui due studi osservazionali, quattro meta-analisi, cinque revisioni sistematiche della letteratura e sette RCT. CONCLUSIONI: dall’analisi di questi articoli emerge che la pratica dell’ipotermia terapeutica indotta non comporta esiti neurologici migliori nei pazienti che sono stati sottoposti a questa pratica rispetto a coloro che non sono stati inclusi, così come non migliora in modo considerevole la qualità di vita di queste persone occorre considerare inoltre che l’induzione dell’ipotermia terapeutica presenta eventi avversi che potrebbero peggiorare il quadro clinico di partenza. PAROLE CHIAVE IN ITALIANO: arresto cardiaco, danno neurologico, ipotermia terapeutica, neuroprotezione, esiti. PAROLE CHIAVE IN INGLESE: cardiac arrest, neurological damage, therapeutic hypothermia, neuroprotection, outcome
valutazione neurologica del paziente nella fase post-arresto cardiaco; revisione di letteratura
BADEA, ELISABETA BIANCA
2021/2022
Abstract
BACKGROUND: cardiac arrest is one of the main causes of death in the world and its impact on the population still remains very significant due to the sequelae, and in particular the neurological ones, reported by patients following a lack of oxygen in the brain. For this reason, greater importance is now placed on post resuscitation assistance and therefore on assistance in the post cardiac arrest phase. PURPOSE AND OBJECTIVES: this literature review has as its main purpose to demonstrate the clinical efficacy of therapeutic hypothermia, the objectives instead are to analyze the pros and cons of using this clinical practice, considering the evolution of the methodologies used and the knowledge now available METHODOLOGY: Systematic literature review was chosen as the modality. The information was taken from secondary online and paper sources for the background topics while the results were searched in the following online databases: Google Scholar, Cinahl, Cochrane and Pubmed using the Boolean operators AND and OR in the various strings of Research. At the end I analyzed, as eligible for the pre-established inclusion criteria, 18 articles to elaborate the results of the thesis. RESULTS: Eighteen articles were selected and considered, including two observational studies, four meta-analyzes, five systematic literature reviews and seven RCTs. CONCLUSIONS: from the analysis of these articles it emerges that the practice of induced therapeutic hypothermia does not lead to better neurological outcomes in patients who have undergone this practice than in those who have not been included, nor does it significantly improve the quality of life of these people it is also necessary to consider that the induction of therapeutic hypothermia presents adverse events that could worsen the initial clinical picture. KEYWORDS IN ITALIAN: cardiac arrest, neurological damage, therapeutic hypothermia, neuroprotection, outcomes. KEYWORDS: cardiac arrest, neurological damage, therapeutic hypothermia, neuroprotection, outcomeFile | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/38204