Hypothermia for head injuries

[iMac]

One of the local services I work is doing a study regarding the treatment of TBI by taking the body temp down in the hopes to diminish brain damage. Read articles below.

I want to see some opinions. Any of you seen or believe hypothermia can in fact have some significant long term effects, any of currently have any of this in your protocols???

http://www.cochrane.org/reviews/en/ab001048.html

http://www.pulmonaryreviews.com/apr01/pr_a...ypothermia.html

http://www.ncbi.nlm.nih.gov/sites/entrez?d...;indexed=google

[AZCEP]

Medscape recently had an article about using therapeutic hypothermia for hemorraghic shock, but I can't seem to find it.

It seems that induced hypothermia is the next "magic bullet" in healthcare. Many are studying if it will benefit a wide range of patient situations.

http://www.medscape.com/viewarticle/405605

[OVeractiveBrain]

As always, my two cents.

Hypothermia is the wave of the future. All ischemic injury is reduced by hypothermia. Whether its edema of a spinal cord or survival from a cerebral hemmorhage, hypothermia improves outcomes.

Studies have shown it is effective to reduce ischemic damage, improve survival rates and neurologic outcomes of cardiac arrest (trauma and nontraumatic), spinal injuries (as in the case of the C4 fractured football player with national coverage), etc.

Are you hurt? Are you going to lose tissue? Freeze em. Just make sure you sedate them first.

Overactive

[vs-eh?]

The last VF arrest I did (keep in mind witnessed by medical personal with CPR, patient was young, and we were on seen quickly), the hospital applied the ROC study hypothermia treatment to them within minutes upon arriving to the ER.

It looked promising.

If I shake their hand, I'll let you know.

[piuteemt-I]

we recently responded to a 1 car mva, the driver in the car ended up with severe head trauma, he was unconcious in the car for more than three hours, the temperature outside was only 19 degrees, i seriously think if not for the cold that kid would have died, hes still not out of the woods but coldness was a good thing in this case

[AnthonyM83]

None of those studies posted were very promising....overall theme seemed to be that hypothermia for neuro injuries is NOT working...though that doesn't mean they can't perfect the technique eventually.

[Lone Star]

When I had my craniotomy to remove a giant cerebral aneurysm, they intentionally induced hypothermia in order to expand the time frame that they could have the skull open from 15-30 minutes.

Only 'drawback' to this was during the 'rewarming process', I suffered asystole twice.

I can tell you from personal experience, getting 'zapped' twice makes your chest hurt for a few days after!

[paramedicmike]

Interesting this came up when it did. This story from the Portland (Maine) Press Herald was linked off of Flightweb's home page.

Not a scientific review by any stretch of the imagination. However, it's a good story with a positive outcome.

-be safe