THERAPEUTIC HYPOTHERMIA FOR ORGAN PROTECTION IN CRITICAL CARE
Keywords:
hypothermia, critical care, intracerebral hematoma, cardiogenic shockAbstract
58 patients with intracerebral hematomas (n=44) and cardiogenic shock (n=14) were included in the study to assess the effectiveness of therapeutic hypothermia (TH) according to the changes in systemic and cerebral hemodynamics, leading to organ dysfunction. A wide range of methods and tool were used for monitoring. Positive effects of TH on the peripheral and cerebral blood flow have been found. Moreover, the initiation of TH reduced post-hypoxic encephalopathy as well as the signs of hypoperfusion of splanhnic circulation. TH produced a positive effect on the course of multiple organ dysfunction syndrome. Mortality rate in the TH group slightly decreased compared to the control group. An array of relevant issues is proposed for further sudies. The initiation of non-invasive TH does not interfere with other management strategies. TH combined with other intensive care modalities appears to be an effective option for protecting organs against the deleterious effects of hypoxia. The initiation of TH, particularly in neurosurgical patients, requires advanced monitoring. TH is a high effective modality in intensive care of nontraumatic subarachnoid hemorrhage.
References
Терапевтическая гипотермия: возможности и перспективы / Е. В. Григорьев, Д. Л Шукевич, Г. П. Плотников, Н. С. Тихонов // Клиническая медицина. – 2014. – № 9. – С. 9–16.
Персистирующий синдром полиорганной недостаточности / E. В. Григорьев, Д. Л. Шукевич, Г. П. Плотников, А. С. Головкин // Патология циркуляции и кардиохирургии. – 2014. – № 3. – С. 82–86.
Butrov А. V. Guidelines for therapeutic hypothermia in patients after ischemic stroke / А. V. Butrov // RUDN University. – 2013. – P. 52.
Kulikova V. P. Ultrasound diagnostics of vascular diseases / V. P. Kulikova // Strom. – 2007. – Р. 512.
Neurologic and cardiac benefits of therapeutic hypothermia / S. Azmoon, S. Demarest, A. L. Pucillo [et al.] // Cardiology in Review. – 2011. – Vol. 19 (3). – P. 108–114.
Choi H. A. Hypothermia for acute brain injury – mechanisms and practical aspects / H. A. Choi, N. Badjatia, S. A. Mayer // Nat Rev Neurol. – 2012. – N 8. – P. 214–222.
Dietrich W. D. The evidence for hypothermia as a neuroprotectant in traumatic brain injury / W. D. Dietrich, H. M. Bramett // Neurotherapeutics. – 2010. – N 7. – P. 43–50.
Drury P. P. Mechanisms of hypothermic neuroprotection / P. P. Drury, L. Bennet, A. J. Gunn // Semin Fetal Neonatal Med. – 2010. – N 15. – P. 287–292.
Guidelines for the early management of patients with acute ischemic stroke / C. J. Edward, J. L. Saver, H. P. Adams [et al.] // Stroke. – 2013. – Vol. 44. – P. 870–947.
ICTuS-L Investigators. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results / T. M. Hemmen, R. Raman, K. Z. Guluma [et al.] // Stroke. – 2010. – N 41. – P. 2265–2270.
A Pilot Study of Rapid Cooling by Cold Saline and Endovascular Cooling Before Reperfusion in Patients With ST-Elevation Myocardial Infarction / M. Götberg, G. K. Olivecrona, S. Koul [et al.] // Circ Cardiovasc Interv. – 2010. – Aug 24. [Epub ahead of print] 12. Hypothermia reduces perihemorrhagic edema after intracerebral hemorrhage / R. Kollmar, D. Staykov, A. Dörfler [et al.] // Stroke. – 2010. – N 41. – P. 1684–1689.
American Heart Association. Part 9: post-cardiac arrest care. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care / M. A. Peberdy, C. W. Callaway, R. W. Neumar [et al.] // Circulation. – 2010. – N 122, suppl 18/3. – P. 768–786.
Sadaka F. Therapeutic hypothermia for the management of intracranial hypertension in severe traumatic brain injury: a systematic review / F. Sadaka, C. Veremakis // Brain Inj. – 2012. – N 26. – P. 899–908.
Therapeutic hypothermia after cardiac arrest in clinical practice: review and compilation of recent experiences / E. Sagalyn, R. A. Band, D. F. Gaieski, B. S. Abella // Crit Care Med. – 2009. – N 37, suppl. 7 . – P. 223–226.
Shah P. S. Hypothermia: a systematic review and meta-analysis of clinical trials / P. S. Shah // Seminars in Fetal and Neonatal Medicine. – 2010. – Vol. 15. – P. 238–246.
Wiersinga W. J. Current insights in sepsis: from pathogenesis to new treatment targets / W. J. Wiersinga // Curr Opin in Crit Care. – 2011. – N 17 (5). – P. 480–486.
Wu T. C. Hypothermia for acute ischaemic stroke / T. C. Wu, J. C. Grotta // Lancet // Neurol. – 2013. – N 12. – P. 275–284.
