William L Baker, Giovanni Geronila, Ranya Kallur, Adam Noyes, Lindsay Smyth, John T Stiles, Kelley N Sawyer and Justin B Lundbye
Effect of Neuromuscular Blockers on Outcomes in Patients Receiving Therapeutic Hypothermia Following Cardiac Arrest
The use of mild therapeutic hypothermia therapy (MTH) for the preservation of neurological function and improvement in survival after cardiac arrest has been well established. Complications of MTH include electrolyte shifting, hypercoagulability, hyperglycemia, and seizures, among others. Additionally, the prevention of shivering is important as it can negate the beneficial effects of MTH through a variety of mechanisms. These include increased oxygen consumption, increased metabolic demands, and increases in intracranial pressure. Current guidelines and numerous clinical trial protocols recommend the use of sedatives and neuromuscular blockers (NMBs) to prevent shivering during initial cooling.
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