The study of systemic general circulation disturbance during the initiation of therapeutic hypothermia: Pit fall of hypothermia
Mitsuru Honda1, Kyosuke Yokota1, Ryo Ichibayashi1, Katsunori Yoshihara1, Hiroyuki Masuda2, Hiroyuki Uekusa2, Yoshikatsu Seiki2, Jun Nomoto2, Takeki Nagao3, Taichi Kishi4, Shigeru Sase5
1 Department of Critical Care Center, Toho University Medical Center, Omori Hospital, Ota-ku, Tokyo, Japan
2 Department of Neurosurgery, Toho University Medical Center, Omori Hospital, Ota-ku, Tokyo, Japan
3 Department of Neurosurgery, Toho University Medical Center, Sakura Hospital, Ota-ku, Tokyo, Japan
4 Education Planning and Development, School of Medicine, Toho University, R and D Division, Anzai Medical Co., Ltd, Ota-ku, Tokyo, Japan
5 Faculty of Medicine, Toho University, R and D Division, Anzai Medical Co., Ltd, Ota-ku, Tokyo, Japan
Department of Critical Care Center, Toho University Medical Center Omori Hospital, 6-11-1 Omori-Nishi, Ota- ku, Tokyo 143-8541
Source of Support: None, Conflict of Interest: None
Aims: Neurointensive care has reduced the mortality and improved the outcome of patients for severe brain damage, over recent decades, and made it possible to perform this therapy in safety. However, we have to understand the complications of this therapy well. The purpose of our study was to determine the systemic circulation disturbance during the initiation of therapeutic hypothermia by using this continuous neurointensive monitoring system.
Materials and Methods: Ten severe brain damage patients treated with hypothermia were enrolled. All patients had Glasgow Coma Scale (GCS) less than or equal to 8, on admission.
Results: We verified that heart rate, cardiac output, and oxygen delivery index (DO2I) decreased with decreasing core temperature. We recognized that depressed cardiac index (CI) was attributed to bradycardia, dehydration, and increased systemic vascular resistance index (SVRI) upon initiation of hypothermia. Conclusion: Although the hypothermia has a therapeutic role in severe brain damage patients, we have to carry out this therapy while maintaining their cardiac output using multimodality monitoring devices during hypothermia period.