The Effect of Therapeutic Temperature Management on Cell Death and Apoptosis in Resuscitative Attempts

arrests (CA) occurred in- and out-of-hospital is the plague of the modern day and therapeutic temperature management(TTM) is claimed to be a remedy against this. TTMis practised mainly in the treatment of adult cardiac arrest and neonatal hypoxic-ischemic encephalopathy (HIE). Neurologic injury is the most common cause of death in patients with OHCA. TTM is commonly recommended for survivors of cardiac arrest as a common final pathway of various mechanisms to alleviate the neurologic injury. TTM can be separated into three phases: induction, maintenance and rewarming; and each phase produces several changes in normal physiology. The induction of mild to moderate TTM to a target temperature 32 to 34ºC in the initial hours after cardiac arrest improves the neurologic outcome of resuscitated patients. TTM acts in many fields by affecting several injury mechanisms concurrently to reduce death rate of the brain cell. This article is written to review the current literature to summarize data regarding cellular injury following CA and effects attributed to the procedure of TTM in the emergency setting.