Hypothermia in acute blunt head injury

Cancio, Leopoldo C.; Wortham, William G.; Zimba, Frank A.

doi:10.1016/0300-9572(94)90049-3

Cited by 11 publications

(4 citation statements)

References 126 publications

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“…A literature review, including animal studies, human studies, technique and complications of IH following traumatic brain injury has recently been published 53 .…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

Induced Hypothermia in Intensive Care Medicine

Bernard

1996

Anaesth Intensive Care

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“…A literature review, including animal studies, human studies, technique and complications of IH following traumatic brain injury has recently been published 53 .…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

Induced Hypothermia in Intensive Care Medicine

Bernard

1996

Anaesth Intensive Care

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“…There is increasing interest in the use of this technique in a variety of clinical settings, particularly in head injuries ( 4–7). Whilst hypothermia is of potential benefit in the treatment of traumatic brain injury ( 8), there are a number of problems associated with the im‐ plementation of prolonged hypothermia including cardiovascular, respiratory and haematological effects ( 9).…”

Section: Discussionmentioning

confidence: 99%

The effect of induced hypothermia on the duration of action of atracurium when given by infusion to critically ill children

Playfor

Thomas

Choonara

2000

Pediatric Anesthesia

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The aim of the study was to investigate the effect of induced hypothermia on the offset time of atracurium when given by continuous infusion to critically ill children. Over a period of 8 months, six mechanically ventilated children had a steady-state infusion of atracurium discontinued. The offset time of atracurium was assessed by train-of-four (TOF) stimulation of the ulnar nerve; recording the time taken to reach a TOF ratio of 0.9. Nine assessments were carried out. The mean offset time of atracurium was 82 min. This was significantly longer than in patients with temperatures within the normal physiological range. When considering all assessments, performed both in hypothermic and normothermic patients, there is a strong correlation between rectal temperature and the offset time of atracurium. Prolonged moderate hypothermia has a very significant effect on the offset time of atracurium when given by infusion to critically ill children.

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“…The technique of induction and maintenance of hypothermia have been discussed elsewhere [ 37 ]. Rewarming after a significant period of IH should be slow, because rapid increases in temperature may be associated with increased cerebral oedema, and this neurological deterioration requires prompt recooling [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Experience with prolonged induced hypothermia in severe head injury

1999

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Background:Recent prospective controlled trials of induced moderate hypothermia (32⌓34°C) for relatively short periods (24⌓48 h) in patients with severe head injury have suggested improvement in intracranial pressure control and outcome. It is possible that increased benefit might be achieved if hypothermia was maintained for more periods longer than 48 h, but there is little in the literature on the effects of prolonged moderate hypothermia in adults with severe head injury. We used moderate induced hypothermia (30⌓33°C) in 43 patients with severe head injury for prolonged periods (mean 8 days, range 2⌓19 days).Results:Although nosocomial pneumonia (defined in this study as both new chest radiograph changes and culture of a respiratory pathogen from tracheal aspirate) was quite common (45%), death from sepsis was rare (5%). Other findings included hypokalaemia on induction of hypothermia and a decreasing total white cell and platelet count over 10 days. There were no major cardiac arrhythmias. There was a satisfactory neurological outcome in 20 out of 43 patients (47%).Conclusion:Moderate hypothermia may be induced for more prolonged periods, and is a relatively safe and feasible therapeutic option in the treatment of selected patients with severe traumatic brain injury. Thus, further prospective controlled trials using induced hypothermia for longer periods than 48 h are warranted.

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Hypothermia in acute blunt head injury

Cited by 11 publications

References 126 publications

Induced Hypothermia in Intensive Care Medicine

Induced Hypothermia in Intensive Care Medicine

The effect of induced hypothermia on the duration of action of atracurium when given by infusion to critically ill children

Experience with prolonged induced hypothermia in severe head injury

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