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Original Research

Open Access

Induced mild hypothermia in children

  • RIMANTAS KEVALAS1
  • DOVILE GRINKEVICIUTE1
  • VAIDOTAS GURSKIS1
  • ALGIMANTAS MATUKEVIČIUS2
  • VYTAUTAS RAGAIŠIS2
  • VIDMANTAS BARAUSKAS3

1,Department of Pediatric Diseases Lithuanian University of Health Sciences;Department of Neurosurgery Lithuanian University of Health Sciences;Department of Pediatric Surgery Lithuanian University of Health Sciences

DOI: 10.22514/SV72.102012.2 Vol.7,Issue 2,October 2012 pp.11-16

Published: 29 October 2012

*Corresponding Author(s): RIMANTAS KEVALAS E-mail: rimantas_kevalas@hotmail.com

Abstract

The objective of this study was to measure outcomes and to determine the safety and effectiveness of mild induced hypot-hermia in children after traumatic and posthypoxic brain injury. 

Methods. Forty patients, following traumatic or posthypoxic brain injury, were involved in the study. Mean age was 10.7 ± 0.8 years. Median GCS (Glasgow Coma Scale) was 6.0 (4-7) and mean PIM2 (Pediatric Index of Mortality) 14.6 ± 3.8 %. Results. GOS (Glasgow Outcome Scale) of 5 was assigned for 15 (37.5%) patients, GOS 4 for 14 (35.0%), GOS 3 for 7 (17.5%) and GOS 2 for 4 (10%) patients. The average GOS in patients after severe head trauma was 3.6 ± 0.9 points and in patients with posthypoxic brain injury 5 points, (p < 0.05). No life threatening complications occurred.

Conclusion. Mild induced hypothermia can be safely used in pediatric patents after severe traumatic or posthypoxic brain injury. This method may be of benefit while improving outcomes in children. 

Keywords

traumatic brain injury, posthypoxic brain injury, children, hypothermia, outcome, Pediatric Index of Mortality

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RIMANTAS KEVALAS,DOVILE GRINKEVICIUTE,VAIDOTAS GURSKIS,ALGIMANTAS MATUKEVIČIUS,VYTAUTAS RAGAIŠIS,VIDMANTAS BARAUSKAS. Induced mild hypothermia in children. Signa Vitae. 2012. 7(2);11-16.

References

1. Verive, MJ. Near Drowning [Internet]. 2009 [updated 2009 Apr 29]. Available from: http://www.scribd.com/doc/48799917/Near-Drowning-eMedicine-Specialties

2. Wang H, Olivero W, Wang D, Lanzino G. Cold as a therapeutic agent. Acta Neurochir 2006;148:565-70.

3. Foster K, Stocker C, Schibler A. Controversies of prophylactic hypothermia and the emerging use of brain tissue oxygen tension monitoring and decompressive craniectomy in traumatic brain - injured children. Aust Crit Care 2010;23:4-11.

4. Vincent A. Therapeutic hypothermia for brain injury: the clinical evidence. Anaesthesia 2004;6(3):116-21.

5. Sookplung P, Vavilala MS. What is new in pediatric traumatic brain injury? Curr Opin Anaesthesiol 2009;22:572-8.

6. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out – of – hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346(8):557-63.

7. Holzer M. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346(8):549-56.

8. Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan ER, et al. Whole - body hypothermia for neonates with hypo-xic - ischemic encephalopathy. N Engl J Med 2005;535:1574-84.

9. Hutchinson JS, Ward RE, Lacroix J, Hebert PC, Barnes M, Bohn DJ, et al. Hypothermia therapy after traumatic brain injury in children. N Engl J Med 2008;358(23):2447-56.

10. Berger RP, Adelson PD, Richichi R, Kochanek PM. Serum biomarkers after traumatic and hypoxemic brain injuries: insight into the bioche-mical response of the pediatric brain to inflicted brain injury. Dev Neurosci 2006;28:327-35.

11. Kochanek PM. The brain, the heart, and therapeutic hypothermia. Cleve Clin J Med 2009;76(2):8-12.

12. Adelson PD. Hypothermia following pediatric traumatic brain injury. J Neurotrauma 2009;26:429-36.

13. Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, et al. Treatment of traumatic brain injury with moderate hypo-thermia. N Engl J Med 1997;336(8):540-6.

14. Polderman KH, Joe RTT, Peederman SM, Vandertop WP, Girbes ARJ. Effects of therapeutic hypothermia on intracranial pressure and outcome in patients with severe head injury. Intensive Care Med 2002;28:1563-73.

15. McIntyre LA, Fergusson DA, Hebert PC, Moher D, Hutchinson JS. Prolonged therapeutic hypothermia after traumatic brain injury in adults. JAMA 2003;289(22):2992-9.

16. Bayir H, Adelson PD, Wisniewski SR, Shore P, Lai MY, Brown D, et al. Therapeutic hypothermia preserves antioxidant defenses after severe traumatic brain injury in infants and children. Crit Care Med 2009;37(2):689-95.

17. Polderman KH. Application of therapeutic hypothermia in the intensive care unit. Opportunities and pitfalls of promising treatment modality 

– Part 2: Practical aspects and side effects. Intensive Care Med 2004;30:757-69.

18. Bourdages M, Bigras JL, Farrel CA, Hutchinson J, Lacroix J. Cardiac arrhythmias associated with severe traumatic brain injury and hypo-thermia therapy. Pediatr Crit Care 2010;11(3):408-14.

19. Aibiki M, Kawaguchi S, Maekawa N. Reversible hypophosphatemia during moderate hypothermia therapy for brain – injured patients. Crit Care Med 2001;29(9):1726-30.

20. Polderman KH, Peederman SM, Girbes ARJ. Hypophosphatemia and hypomagnesemia induced by cooling in patients with severe head injury. J Neurosurg 2001;94(5):697-705.

21. Adelson PD, Ragheb J, Kaney P, Brockmeyer D, Beers SR, Brown SD, et al. Phase II clinical trial of moderate hypothermia after severe traumatic brain injury in children. Neurosurgery 2005;56(4):740-54.

22. Hutchinson J, Ward R, Lacroix J, Hebert P, Skippen P, Barnes M, et al. Hypothermia pediatric head injury trial: the value of a pretrial clinical evaluation phase. Dev Neurosci 2006;28(4-5):291-301.

23. Polderman KH. Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet 2008;371:1955-69.

24. Bruel C, Parienti JJ, Marie W, Arrot X, Daubin C, Du Cheiron D, et al. Mild hypothermia during advanced life support: a preliminary study in out – of – hospital cardiac arrest. Crit Care 2008;12(1):R31(doi:10.1186/cc6809).

25. Kim F, Olsufka M, Longstreth WTMJC, Carlbom D, Deem S, Kudenchuk P. Pilot randomized clinical trial of prehospital induction of mild hypothermia in out-of-hospital cardiac arrest patients with a rapid infusion of 4oC normal saline. Circulation 2007;115:3064-70.

26. Grande PO, Reinstrup P, Romner B. Active cooling in traumatic brain - injured patients: a questionable therapy? Acta Anesthesiol Scand 2009;53:1233-8.

27. Gluckman PD, Wyatt JS, Azzopardi D, ballard R, Edwards AD, Ferriero DM. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomized trial. Lancet 2005;365:663-70.

28. Hein OV, Triltsch A, Buch C, Kox WJ, Spies C. Mild hypothermia after near drowning twin toddlers. Crit Care 2004;8(5):R353-R357.

29. Hay AW, Swann DG, Bell K, Walsh TS, Cook B. Therapeutic hypothermia in comatose patients after out – of hospital cardiac arrest. Ana-esthesia 2008;63:15-9.

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