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Hypothermia therapy as an adjuvant therapy for severe ARDS

Lee EK

The management of severe ARDS (Adult respiratory distress syndrome) when maximal ventilator support fails has always been a challenge in places whereby Extracorporeal membrane oxygenation (ECMO) service may not be easily available or it may not be an option. Hypothermia therapy as a main mode of therapy for ARDS had been explored before but the result so far has not been convincing though Villar, had reported some success with hypothermic therapy for patients in 1993 but so far there have been a few recent trials that suggest otherwise. There are however a few case reports that had showed improvement in patients with severe ARDS refractory to other modes of conventional therapies. We would like to share the reports of 2 young males with severe ARDS from community and hospital acquired pneumonia with PaO2/ FiO2 ratio below 100 that was on maximal AC/VC ventilator support of FiO2 of 100% with sedation and muscle relaxants. These 2 patients received adjuvant hypothermia therapy for 24 hours before they were gradually rewarmed to 37°C and weaned off ventilator support over the next 2 weeks. They recovered fully from their pneumonia and were subsequently discharged from the hospital.