Cheap and simple, could it get even cooler? Mild hypothermia and COVID-19.
J Crit Care
; 63: 264-268, 2021 06.
Article
in English
| MEDLINE | ID: covidwho-1060792
ABSTRACT
PURPOSE:
The pathophysiology theories of COVID-19 attach the injury of target organs to faulty immune responses and occasionally hyper-inflammation. The damage frequently extends beyond the respiratory system, accompanying cardiovascular, renal, central nervous system, and/or coagulation derangements. Tumor necrosis factor-α (TNF-α) and interleukins (IL)-1 and - 6 suppression may improve outcomes, as experimentally shown. Targeted therapies have been proposed, but mild therapeutic hypothermia-a more multifaceted approach-could be suitable.FINDINGS:
According to evidence derived from previous applications, therapeutic hypothermia diminishes the release of IL-1, IL-6, and TNF-α in serum and at the tissue level. PaCO2 is reduced and the PaO2/FiO2 ratio is increased, possibly lasting after rewarming. Cooling might mitigate both ventilator and infectious-induced lung injury, and suppress microthrombi development, enhancing V/Q mismatch. Improvements in microhemodynamics and tissue O2 diffusion, along with the ischemia-tolerance heightening of tissues, could be reached. Arrhythmia incidence diminishes. Moreover, hypothermia may address the coagulopathy, promoting normalization of both hypo- and hyper-coagulability patterns, which are apparently sustained after a return to normothermia.CONCLUSIONS:
As per prior therapeutic hypothermia literature, the benefits regarding inflammatory response and organic damage might be seen. Following the safety-cornerstones of the technique, the overall infection rate and infection-related mortality are not expected to rise, and increased viral replication does not seem to be a concern. Therefore, the possibility of a low cost and widely available therapy being capable of improving COVID-19 outcomes deserves further study.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cytokine Release Syndrome
/
SARS-CoV-2
/
COVID-19
/
Hypothermia, Induced
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
J Crit Care
Journal subject:
Critical Care
Year:
2021
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS