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Induced hypothermia in critical care medicine: A review

Bernard, Stephen A. MB, BS, FACEM, FJFICM; Buist, Michael MB, BS, FRACP, FJFICM

doi: 10.1097/01.CCM.0000069731.18472.61
Neurologic Critical Care

Background Clinical trials of induced hypothermia have suggested that this treatment may be beneficial in selected patients with neurologic injury.

Objectives To review the topic of induced hypothermia as a treatment of patients with neurologic and other disorders.

Design Review article.

Interventions None.

Main Results Improved outcome was demonstrated in two prospective, randomized, controlled trials in which induced hypothermia (33°C for 12–24 hrs) was used in patients with anoxic brain injury following resuscitation from prehospital cardiac arrest. In addition, prospective, randomized, controlled trials have been conducted in patients with severe head injury, with variable results. There also have been preliminary clinical studies of induced hypothermia in patients with severe stroke, newborn hypoxic-ischemic encephalopathy, neurologic infection, and hepatic encephalopathy, with promising results. Finally, animal models have suggested that hypothermia that is induced rapidly following traumatic cardiac arrest provides significant neurologic protection and improved survival.

Conclusions Induced hypothermia has a role in selected patients in the intensive care unit. Critical care physicians should be familiar with the physiologic effects, current indications, techniques, and complications of induced hyperthermia.

From the Intensive Care Unit, Dandenong Hospital, Dandenong, Victoria, Australia.

Address requests for reprints to: Dr. Stephen Bernard, Intensive Care Unit, Dandenong Hospital, Victoria, Australia 3175. E-mail s.bernard@southernhealth.org.au

We conclude that jugular bulb, pulmonary artery, and bladder temperatures correlate closely with brain temperature.

© 2003 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins