In my unit we cool patients regularly post cardiac arrest. I understand the basis of this and that the goal is to preserve neurologic function, but can some of you experienced critical care nurses help me understand this concept on a deeper level?

My simple way of thinking is that in a cardiac arrest the brain and other vital organs aren't getting enough oxygenation so some sort of ischemic damage is happening. Hypothermia reduce the oxygenation demand of these organs and allows the organs to be reperfuse while reducing the detrimental effects that comes with ischemia, and inflammatory response from said damage. Also it has something to do with lessening the negative effects of the by products of anaerobic metabolism that the organs were facilitating while the body was meeting its oxygenation need.

This article goes in great depth about the exact benefits of hypothermia. They list about ten million specific ways (give or take) that hypothermia helps, including inhibiting the release of excitatory neurotransmitters that can build up to toxic levels and cause neurons to die, stopping the blood brain barrier from being broken down by enzymes, and slowing the release of pro-inflammatory substances that would otherwise cause swelling and further damage to the brain. It's good reading.

thanks for the article! a lot of really great info in there. I thought the part explaining cold diuresis being a result of an increase in venous return and atrial natriuretic peptide was very interesting.