Comparative evaluation of controllability and safety of therapeutic hypothermia in the intensive care of severe traumatic brain injury.

Authors

  • A. V. Tsarev
  • L. V. Usenko

DOI:

https://doi.org/10.26641/2307-0404.2017.4.117669

Keywords:

trauma brain injury, therapeutic hypothermia, target temperature management, intensive care

Abstract

The article presents the results of a comparative study of control and safety of two technologies of therapeutic hypothermia in intensive care in patients with TBI: an estimate of the rate of its induction, control of its maintenance, dynamics of attaining normothermia. A total of 24 patients with a severe TBI divided into 2 groups were examined: I (n=12) –therapeutic hypothermia with "Blanketrol II" (CSZ) with the use of non-invasive technology to achieve the target core body temperature (Tco) of 34-34.50C; II group (n=12) – carrying out therapeutic hypothermia «Blanketrol - II» with the use of an esophageal device for hypothermia to achieve Tco - 34-34,50С. The mean time from the moment of induction to achievement of the target Tco in group I was 9.5±2.39 hours, in group II – 9±2.70 hours (p>0.05). The maintenance period Tco at the level of ≤34.50C in the II group was greater – 10.5±5.78 compared with 6.83±3.95 hours in patients of the I group (p<0.05). Control of the warming process was significantly higher in group II, which was reflected by a lower mean of Tco value at 24, 28 and 32 hours. There were no clinically significant adverse effects in therapeutic hypothermia.

Author Biographies

A. V. Tsarev

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

L. V. Usenko

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

References

1. Badjatia N, Strongilis M, Buitrago E, Fernandez A, Palestrant D, Parra A, Mayer S. Assessment of the metabolic impact of shivering: the bedside shivering assessment scale (BSAS). Neurocritical Care. 2007;6:228.

2. White MG, Luca LE, Nonner D, et al. Cellular mechanisms of neuronal damage from hyperthermia. Prog. Brain Res. 2007;162:347-71.

3. Soar J, Nolan JP, Bottiger B. European Resus­cita­tion Council Guidelines for Resuscitation 2015. Section 3. Adult advanced life support. Resuscitation. 2015;95:100-47.

4. CarneyN, TottenAM, O’ReillyC, et al. Guid­elines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Brain Trauma Foundation. Neu­rosurgery. 2017;80:6-15.

5. Kochanek PM, Jackson TC. The brain and hy­pothermia – from Aristotle to Target Temperature Mana­gement. Crit. Care Med. 2017;45:305-10.

6. Crompton EM, Lubomirova I, Cotlarcius I. Meta-analysis of therapeutic hypothermia for traumatic brain injury in adult and pediatric patients. Crit. Care Med. 2017;45:575-83.

7. Peterson K, Carson S, Cairney N. Hypothermia treatment for traumatic brain injury: A systematic review and meta-analysis. Journal of Neurotrauma. 2008;26:62-71.

8. Polderman KH. Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet. 2008;371:1955-65.

9. Polderman KH, Herold I. Therapeutic hypo­thermia and controlled normothermia in the ICU: Prac­tical considerations, side effects, and cooling methods Crit. Care Med. 2009;37:1101-20.

10. Nielsen N, Wetterslev J, Cronberg T, et al. Target temperature management at 330C versus 360C after car­diac arrest. NEJM. 2013;369:2197-206.

11. Lundbye JB (Ed.). Therapeutic Hypothermia after Cardiac Arrest. Clinical Application and Management. Heidelberg – New York – London: Springer; 2012.

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Published

2017-12-06

How to Cite

1.
Tsarev AV, Usenko LV. Comparative evaluation of controllability and safety of therapeutic hypothermia in the intensive care of severe traumatic brain injury. Med. perspekt. [Internet]. 2017Dec.6 [cited 2024Dec.19];22(4):56-61. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/117669

Issue

Vol. 22 No. 4 (2017)

Section

CLINICAL MEDICINE

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Copyright (c) 2017 Medicni perspektivi (Medical perspectives)

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