Therapeutic hypothermia in sepsis: to use or not to use?

Therapeutic hypothermia (TH) as part of the postresuscitation care has gained popularity over the last decade. The therapeutic and clinical benefits from this therapy in patients with postcardiac arrest with return of spontaneous circulation are well established [ , ]. Therapeutic hypothermia has also been used experimentally in other clinical conditions such as cerebrovascular accidents, near drowning, newborn hypoxic-ischemic encephalopathy, hepatic encephalopathy, acute respiratory distress syndrome, and bacterial meningitis, among others [ ]. However, despite the current accepted indications and multiple promising research data to support its use in other conditions, clinicians are reluctant to use it on a regular basis. One of the major concerns that prevent the use of this intervention by those caring for critically ill patients has been the “association” of TH with a decreased capacity to clear infections. This association is the result of a single study performed in the 1960s [ ]. This common misconception requires some clarification.