Is therapeutic hypotermia viable in our region as a new option for sudden cardiac arrest caused by acute myocardial infarction?

To the editor of JCCM
Therapeutic hypothermia has become a widely accepted option for management of patients with cardiac arrest occurring in the setting of an Acute Myocardial Infarction [1]. Infarct size is one of the major determinants of future evolution of patients with myocardial infarction and every attempt should be made in order to reduce the amount of infarcted, necrotic myocardium. It has been suggested that induction of hypothermia before performing a percutaneous coronary intervention for urgent revascularisation might play a decisive role in reduction of infarct size [1]. In the same time, applying a mild cooling protocol in patients surviving an out-of-hospital cardiac arrest might significantly improve the rates of neurologically intact survivals on long term [2].
It has been proved that via application of therapeutic hypothermia protocols, a 7% reduction in cerebral metabolism can be achieved per each 1oC of hypothermia, that would further lead to a decrease consumption of glucose and oxygen and prevention of neuronal injury [2]. All these are strongly correlated with the evolution of the neurological status in the post-resuscitation period. [More]