Effects of Hypothermia on Systemic and Intracranial Hemodynamics and Metabolism

摘要

Since 1994, we have utilized therapeutic hypothermia in patients with severe traumatic brain injury. In 2000, we altered the target temperature to 35degC from the former 33degC, as our findings suggested that cooling to 35degC is sufficient to control intracranial hypertension, and that hypothermia below 35degC may predispose patients to persistent cumulative oxygen debt, which may be associated with an increased risk of complications. Intracranial pressure and cerebral perfusion pressure controls achieved at 35degC hypothermia were found to be comparable to those achieved at 33degC. Furthermore, 35degC hypothermic patients exhibited a significant improvement in the decline of systemic oxygen consumption, Although there were no statistically significant differences between the 33 and 35degC hypothermic patients in the incidence of infectious complications and clinical outcomes, 35degC seems to be the optimal temperature to control intracranial hypertension in patients with severe traumatic brain injury.