Cool to 32-34ºC as soon as possible (within 4 hours)
Strict maintenance of temperature at 36ºC may have similar benefits
Initiate rewarming 24 hrs after target temperature was reached
Cooling methods
Maintain at 32-34ºC with 2 cooling blankets to sandwich the pt, with sheets covering the blankets to protect skin
Alternatively, use heat exchange device (Icy Cath) or 4°C IVF at 30 cc/kg over 30 min
Cooling pads on the thighs and abdomen (Arctic Sun)
Supplement with ice packs to groin, chest, axillae, neck until 34ºC reached
Prevention of shivering and paralysis
Use benzodiazepines
Paralytics only if needed, and ensure patient fully sedated
Strict maintenance of temperature at 36ºC may have similar benefits
Maintain at 32-34ºC with 2 cooling blankets to sandwich the pt, with sheets covering the blankets to protect skin
Alternatively, use heat exchange device (Icy Cath) or 4°C IVF at 30 cc/kg over 30 min
Cooling pads on the thighs and abdomen (Arctic Sun)
Supplement with ice packs to groin, chest, axillae, neck until 34ºC reached
Use benzodiazepines
Paralytics only if needed, and ensure patient fully sedated
Therapeutic hypothermia
Ventriculoperitoneal shunt drainage
ICU sedation
Extracorporeal membrane oxygenation
Traumatic asphyxia
Ventriculoperitoneal shunt obstruction
Advanced airway adjuncts
Neonatal resuscitation