#pcp15 | In With The New, Out With The Old

In With The New, Out With The Old

Reducing core body temperature to 32-34C during the first 12 to 24 hours post-arrest has led to improved neurologic outcome by reducing hypoxemic-induced encephalopathy. Due to numerous trials showing benefits of hypothermia, it has been considered the fifth link in ACLS. Transfusion of blood products within the first six hours of recognition of septic shock to maintain hematocrit of 30, hemoglobin of 100 and oxygen saturation of more than 70% improved patient outcomes. Although associated with various complications such as TRALI, TRIM and infections, its benefits outweighs the risk. ECMO maintains hemodynamic stability by providing both circulatory and oxygenation support. It is utilized when PF ratio drops to 80 or less, paCO2 is greater than 80mmHg for at least 8-10 days. It has been shown to improve patient outcomes however its unavailability in the Philippines makes it unpopular.