Therapeutic hypothermia for traumatic brain injury.

Details

Ressource 1Download: serval:BIB_17F79D816B57.P001 (608.83 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_17F79D816B57
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Therapeutic hypothermia for traumatic brain injury.
Journal
Current Neurology and Neuroscience Reports
Author(s)
Urbano L.A., Oddo M.
ISSN
1534-6293 (Electronic)
ISSN-L
1528-4042
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
12
Number
5
Pages
580-591
Language
english
Notes
Publication types: Journal Article WOS document type : Review
Abstract
Experimental evidence demonstrates that therapeutic temperature modulation with the use of mild induced hypothermia (MIH, defined as the maintenance of body temperature at 32-35 °C) exerts significant neuroprotection and attenuates secondary cerebral insults after traumatic brain injury (TBI). In adult TBI patients, MIH has been used during the acute "early" phase as prophylactic neuroprotectant and in the sub-acute "late" phase to control brain edema. When used to control brain edema, MIH is effective in reducing elevated intracranial pressure (ICP), and is a valid therapy of refractory intracranial hypertension in TBI patients. Based on the available evidence, we recommend: applying standardized algorithms for the management of induced cooling; paying attention to limit potential side effects (shivering, infections, electrolyte disorders, arrhythmias, reduced cardiac output); and using controlled, slow (0.1-0.2 °C/h) rewarming, to avoid rebound ICP. The optimal temperature target should be titrated to maintain ICP <20 mmHg and to avoid temperatures <35 °C. The duration of cooling should be individualized until the resolution of brain edema, and may be longer than 48 h. Patients with refractory elevated ICP following focal TBI (e.g. hemorrhagic contusions) may respond better to MIH than those with diffuse injury. Randomized controlled trials are underway to evaluate the impact of MIH on neurological outcome in adult TBI patients with elevated ICP. The use of MIH as prophylactic neuroprotectant in the early phase of adult TBI is not supported by clinical evidence and is not recommended.
Pubmed
Web of science
Open Access
Yes
Create date
11/10/2012 16:43
Last modification date
01/10/2019 6:17
Usage data