Therapeutic hypothermia (TH) is recommended therapy that reduces ischemic injury
aft er low blood fl ow. It should be initiated soon in patients with ischemic injury and mild
hypothermia (32-35?C for 12-24 hours). Postresuscitation Syndrome (PRS) is a pathology that
is performed aft er return of spontaneous circulation following successful cardiopulmonary
resuscitation (CPR). Th e pathophysiology is referred to global ischaemia and reperfusion injury
due to cardiac arrest and CPR. It is a kind of ?septic infl ammatory response syndrome?. TH is an
accepted and valuable treatment option for PRS presented with neurological and cardiovascular
impairment and multi-organ dysfunction. Indication of TH for both initial rhythms of cardiac
arrests including shockable and non-shockable rhythms are still underinvestigation.
Lactic acidosis contributes to the pathophysiology of PRS including neurologic impairment.
However, lactate levels are also elevated during TH applications. Lactic acidosis injures and
inactivates mitochondria. Increased lactate levels (3-5 mmol/L) associated with reperfusion and
hypothermia may be treated by effi cient oxygen delivery. While administering TH aft er CPR,
hemodynamic values, organ function markers, lactat levels and neurologic status should be
evaluated. During TH, at the point that reaches to goal temperature, lactate blood levels? stable
or decreasing values are predictive for good neurologic outcomes. At that point still increasing
values reveal worsening neurologic outcomes or mortality.
It is evident that TH is one of the important therapy of PRS. In my presentation, I will also
represent our clinic?s experience and studies about lactate levels and importance of follow up as
a good biomarker of neurologic functions aft er CPR.
Sule Akin has completed her medical education in Cukurova University Medical School and also Anesthesiology
and Reanimation Department. She is an Associated Professor in Baskent University Anesthesiology and
Critical Care Medicine Department and works as a consultant. Her interests in the area are neuroanesthesia,
anesthesia for orthopedics, thoracic surgery and organ transplantation, neuro and surgical-critical care and
cardiopulmonary resuscitation. She works and teaches in these fi elds. She also has many national and
international publications about the interested areas. She is the instructor and course-director of ?European
Resuscitation Council? and reviews for articles for national journals.
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