Intracranial Pressure Increases During Rewarming Period After Mild Therapeutic Hypothermia in Postcardiac Arrest Patients
| Autor: | Hiromichi Naito, Clifton W. Callaway, Eiji Isotani, Shingo Hagioka, Naoki Morimoto |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors Intracranial Pressure Traumatic brain injury Brain Edema Core temperature Critical Care and Intensive Care Medicine Cerebral edema Young Adult 03 medical and health sciences 0302 clinical medicine Hypothermia Induced Risk Factors Humans Medicine Coma Rewarming Cerebral perfusion pressure Aged Intracranial pressure integumentary system business.industry musculoskeletal neural and ocular physiology 030208 emergency & critical care medicine Middle Aged Hypothermia medicine.disease humanities Heart Arrest nervous system diseases Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Time course Female Intracranial Hypertension medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Therapeutic Hypothermia and Temperature Management. 6:189-193 |
| ISSN: | 2153-7933 2153-7658 |
| DOI: | 10.1089/ther.2016.0009 |
| Popis: | Elevation of intracranial pressure (ICP) may worsen brain injury and neurological outcome. Studies on the use of therapeutic hypothermia (TH) for traumatic brain injury suggests that rapid rewarming from TH is associated with elevated ICP and poorer outcomes. However, few studies describe the time course of ICP changes during TH/rewarming after cardiac arrest (CA). In this study, we observed the changes in ICP during mild TH and rewarming after CA. Secondarily, we examined whether ICP is related to outcome. We studied comatose patients resuscitated from CA, who were treated with TH and who had ICP monitored. Target core temperature was 34°C for 24 h and target rewarming rate was 0.25°C/h. ICP and cerebral perfusion pressure (CPP) were monitored during the period. Outcome was rated as cerebral performance category. In nine patients, ICP increased during TH and rewarming (6.0 [4.0-9.0] mmHg to 16.0 [12.0-26.0] mmHg, p = 0.008). CPP did not change during the period (83.3 [80.1-91.0] mmHg to 74.3 [52.0-87.3] mmHg). Higher ICP was associated with worse outcomes (p = 0.009). All the cases with ICP >25 mmHg or CPP |
| Databáze: | OpenAIRE |
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