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Therapeutic Hypothermia. Bryan Imayanagita 12/2/11 UCI T-RAP. Background. Protective hypothermia Reduce ischemic injury to tissue Invasive and non invasive treatments Can reduce ischemic brain injuries. Categories of Treatment. Hypothermia therapy for neonatal encephalopathy

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Therapeutic hypothermia

Therapeutic Hypothermia

Bryan Imayanagita

12/2/11

UCI T-RAP


Background
Background

  • Protective hypothermia

  • Reduce ischemic injury to tissue

  • Invasive and non invasive treatments

  • Can reduce ischemic brain injuries


Categories of treatment
Categories of Treatment

  • Hypothermia therapy for neonatal encephalopathy

  • Cardiac arrest

  • Stroke

  • TBI/spinal cord injury

  • Neurogenic Fever


Mechanism of protection by hypothermia
Mechanism of Protection by Hypothermia

  • Slowing of cellular metabolism (every 1 degree, metabolism slows by 5-7%)

  • Can act as a neuroprotectant

  • Oxygen deprivation leads to imbalance in ion homeostasis (insufficient ATP)

  • Cell membrane made more impermeable to prevent flow of ions


Invasive treatment

Invasive: cooling catheters

NS through femoral vein

Control unit to bring down temperature (very accurate)

complications

Bleeding

Infection

DVT

Invasive Treatment


Non invasive treatment
Non Invasive Treatment

  • Cold water blanket, torso vest, leg wraps

  • Can overshoot or undershoot target temperature


References
References

  • Diringer, Michael. “Treatment of fever in the neurologic intensive care unit with a catheter-based heat exchange system.” Crit Care Med. Vol. 32, No. 2. 2004.

  • Holzer, Michael. “Mild Hypothermia to Improve the Neurologic Outcome After Cardiac Arrest.” New England Journal of Medicine. (2002) Vol. 346, No. 8.

  • Polderman, Kees H. “Application of therapeutic hypothermia in the ICU.” Intensive Care Med. (2004) 30:556-575.

  • Schwab, S. et al. “Moderate Hypothermia in the Treatment of Patients with Severe Middle Cerebral Artery Infarction.” American Heart Association. pg. 2461-2466

  • Simosa, H. et al. “Increased Risk of Deep Venous Thrombosis with Endovascular Cooling in Patients with Traumatic Head Injury."


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