Skip to main content
Top
Published in: Intensive Care Medicine 5/2004

01-05-2004 | Review

Application of therapeutic hypothermia in the intensive care unit

Opportunities and pitfalls of a promising treatment modality—Part 2: Practical aspects and side effects

Author: Kees H. Polderman

Published in: Intensive Care Medicine | Issue 5/2004

Login to get access

Abstract

Induced hypothermia can be used to protect the brain from post-ischemic and traumatic neurological injury. Potential clinical applications and the available evidence are discussed in a separate paper. This review focuses on the practical aspects of cooling and physiological changes induced by hypothermia, as well as the potential side effects that may develop. These side effects can be serious and, if not properly dealt with, may negate some or all of hypothermia’s potential benefits. However, many of these side effects can be prevented or modified by high-quality intensive care treatment, which should include careful monitoring of fluid balance, tight control of metabolic aspects such as glucose and electrolyte levels, prevention of infectious complications and various other interventions. The speed and duration of cooling and rate of re-warming are key factors in determining whether hypothermia will be effective; however, the risk of side effects also increases with longer duration. Realizing hypothermia’s full therapeutic potential will therefore require meticulous attention to the prevention and/or early treatment of side effects, as well as a basic knowledge and understanding of the underlying physiological and pathophysiological mechanisms. These and other, related issues are dealt with in this review.
Literature
2.
go back to reference Tikuisis P, Bell DG, Jacobs I (1991) Shivering onset, metabolic response and convective heat transfer during cold air exposure. J Appl Physiol 70:1996–2002 Tikuisis P, Bell DG, Jacobs I (1991) Shivering onset, metabolic response and convective heat transfer during cold air exposure. J Appl Physiol 70:1996–2002
3.
go back to reference English MJM (2001) Physical principles of heat transfer. Curr Anaesth Crit Care 12:66–71. DOI 10.1054/cacc.2001.0331CrossRef English MJM (2001) Physical principles of heat transfer. Curr Anaesth Crit Care 12:66–71. DOI 10.1054/cacc.2001.0331CrossRef
4.
go back to reference Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, Cheng C (1995) Heat flow and distribution during induction of general anesthesia. Anesthesiology 82:662–673CrossRefPubMed Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, Cheng C (1995) Heat flow and distribution during induction of general anesthesia. Anesthesiology 82:662–673CrossRefPubMed
5.
go back to reference Frank SM, Fleisher LA, Olson KF, Gorman RB, Higgins MS, Breslow MJ, Sitzmann JV, Beattie C (1995) Multivariate determinates of early postoperative oxygen consumption: the effects of shivering, core temperature and gender. Anesthesiology 83:241–249 Frank SM, Fleisher LA, Olson KF, Gorman RB, Higgins MS, Breslow MJ, Sitzmann JV, Beattie C (1995) Multivariate determinates of early postoperative oxygen consumption: the effects of shivering, core temperature and gender. Anesthesiology 83:241–249
6.
go back to reference Horvath SM, Spurr GB, Hutt BK, Hamilton LH (1956) Metabolic cost of shivering. J Appl Physiol 8:595–602PubMed Horvath SM, Spurr GB, Hutt BK, Hamilton LH (1956) Metabolic cost of shivering. J Appl Physiol 8:595–602PubMed
7.
go back to reference Milde LN (1992) Clinical use of mild hypothermia for brain protection: a dream revisited. J Neurosurg Anesthesiol 4:211–215PubMed Milde LN (1992) Clinical use of mild hypothermia for brain protection: a dream revisited. J Neurosurg Anesthesiol 4:211–215PubMed
8.
go back to reference Small DL, Morley P, Buchan AM (1999). Biology of ischemic cerebral cell death. Prog Cardiovasc Dis 42:185–207PubMed Small DL, Morley P, Buchan AM (1999). Biology of ischemic cerebral cell death. Prog Cardiovasc Dis 42:185–207PubMed
9.
go back to reference Schaller B, Graf R (2003) Hypothermia and stroke: the pathophysiological background. Pathophysiology 10:7–35CrossRefPubMed Schaller B, Graf R (2003) Hypothermia and stroke: the pathophysiological background. Pathophysiology 10:7–35CrossRefPubMed
10.
go back to reference Fischer S, Renz D, Wiesnet M, Schaper W, Karliczek GF (1999) Hypothermia abolishes hypoxia-induced hyperpermeability in brain microvessel endothelial cells. Brain Res Mol Brain Res 74:135–144CrossRefPubMed Fischer S, Renz D, Wiesnet M, Schaper W, Karliczek GF (1999) Hypothermia abolishes hypoxia-induced hyperpermeability in brain microvessel endothelial cells. Brain Res Mol Brain Res 74:135–144CrossRefPubMed
11.
go back to reference Chopp M, Knight R, Tidwell CD, Helpern JA, Brown E, Welch KM (1989) The metabolic effects of mild hypothermia on global cerebral ischemia and recirculation in the cat: comparison to normothermia and hyperthermia. J Cereb Blood Flow Metab 9:141–148PubMed Chopp M, Knight R, Tidwell CD, Helpern JA, Brown E, Welch KM (1989) The metabolic effects of mild hypothermia on global cerebral ischemia and recirculation in the cat: comparison to normothermia and hyperthermia. J Cereb Blood Flow Metab 9:141–148PubMed
12.
go back to reference Kinoshita K, Chatzipanteli K, Alonso OF, Howard M, Dietrich WD (2002) The effect of brain temperature on hemoglobin extravasation after traumatic brain injury. J Neurosurg 97:945–953PubMed Kinoshita K, Chatzipanteli K, Alonso OF, Howard M, Dietrich WD (2002) The effect of brain temperature on hemoglobin extravasation after traumatic brain injury. J Neurosurg 97:945–953PubMed
13.
go back to reference Chi OZ, Liu X, Weiss HR (2001) Effects of mild hypothermia on blood-brain barrier disruption during isoflurane or pentobarbital anesthesia. Anesthesiology 95:933–938CrossRefPubMed Chi OZ, Liu X, Weiss HR (2001) Effects of mild hypothermia on blood-brain barrier disruption during isoflurane or pentobarbital anesthesia. Anesthesiology 95:933–938CrossRefPubMed
14.
go back to reference Huang ZG, Xue D, Preston E, Karbalai H, Buchan AM (1999) Biphasic opening of the blood-brain barrier following transient focal ischemia: effects of hypothermia. Can J Neurol Sci 26:298–304PubMed Huang ZG, Xue D, Preston E, Karbalai H, Buchan AM (1999) Biphasic opening of the blood-brain barrier following transient focal ischemia: effects of hypothermia. Can J Neurol Sci 26:298–304PubMed
15.
go back to reference Siesjo BK, Bengtsson F, Grampp W, Theander S (1989) Calcium, excitotoxins and neuronal death in brain. Ann NY Acad Sci 568:234–251PubMed Siesjo BK, Bengtsson F, Grampp W, Theander S (1989) Calcium, excitotoxins and neuronal death in brain. Ann NY Acad Sci 568:234–251PubMed
16.
go back to reference Kimura A, Sakurada S, Ohkuni H, Todome Y, Kurata K (2002) Moderate hypothermia delays proinflammatory cytokine production of human peripheral blood mononuclear cells. Crit Care Med 30:1499–1502CrossRefPubMed Kimura A, Sakurada S, Ohkuni H, Todome Y, Kurata K (2002) Moderate hypothermia delays proinflammatory cytokine production of human peripheral blood mononuclear cells. Crit Care Med 30:1499–1502CrossRefPubMed
17.
go back to reference Aibiki M, Maekawa S, Ogura S, Kinoshita Y, Kawai N, Yokono S (1999) Effect of moderate hypothermia on systemic and internal jugular plasma IL-6 levels after traumatic brain injury in humans. J Neurotraum 16:225–232 Aibiki M, Maekawa S, Ogura S, Kinoshita Y, Kawai N, Yokono S (1999) Effect of moderate hypothermia on systemic and internal jugular plasma IL-6 levels after traumatic brain injury in humans. J Neurotraum 16:225–232
18.
go back to reference Frank SM (2001) Consequences of hypothermia. Curr Anaesth Crit Care 12:79–86CrossRef Frank SM (2001) Consequences of hypothermia. Curr Anaesth Crit Care 12:79–86CrossRef
19.
go back to reference Busto R, Globus MY, Dietrich WD, Martinez E, Valdés I, Ginsberg MD (1989) Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain. Stroke 20:904–910PubMed Busto R, Globus MY, Dietrich WD, Martinez E, Valdés I, Ginsberg MD (1989) Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain. Stroke 20:904–910PubMed
20.
go back to reference Dempsey RJ, Combs DJ, Maley ME, Cowen DE, Roy MW, Donaldson DL (1987) Moderate hypothermia reduces postischemic edema development and leukotriene production. Neurosurgery 21:177–181PubMed Dempsey RJ, Combs DJ, Maley ME, Cowen DE, Roy MW, Donaldson DL (1987) Moderate hypothermia reduces postischemic edema development and leukotriene production. Neurosurgery 21:177–181PubMed
21.
go back to reference Frank SM, Satitpunwaycha P, Bruce SR, Herscovitch P, Goldstein DS (2003) Increased myocardial perfusion and sympathoadrenal activation during mild core hypothermia in awake humans. Clin Sci (Lond) 104:503–508 Frank SM, Satitpunwaycha P, Bruce SR, Herscovitch P, Goldstein DS (2003) Increased myocardial perfusion and sympathoadrenal activation during mild core hypothermia in awake humans. Clin Sci (Lond) 104:503–508
22.
go back to reference Nabel EG, Ganz P, Gordon JB, Alexander RW, Selwyn AP (1988) Dilation of normal and constriction of atherosclerotic coronary arteries caused by the cold pressor test. Circulation 77:43–52PubMed Nabel EG, Ganz P, Gordon JB, Alexander RW, Selwyn AP (1988) Dilation of normal and constriction of atherosclerotic coronary arteries caused by the cold pressor test. Circulation 77:43–52PubMed
23.
go back to reference Hale SL, Dae MW, Kloner RA (2003) Marked reduction in no-reflow with late initiation of hypothermia in a rabbit myocardial infarct model. J Am Coll Cardiol 41 (6 Suppl B):381–382CrossRefPubMed Hale SL, Dae MW, Kloner RA (2003) Marked reduction in no-reflow with late initiation of hypothermia in a rabbit myocardial infarct model. J Am Coll Cardiol 41 (6 Suppl B):381–382CrossRefPubMed
24.
go back to reference Hale SL, Dae MW, Kloner RA (2003) Hypothermia during reperfusion limits ‘no-reflow’ injury in a rabbit model of acute myocardial infarction. Cardiovasc Res 59:715–722CrossRefPubMed Hale SL, Dae MW, Kloner RA (2003) Hypothermia during reperfusion limits ‘no-reflow’ injury in a rabbit model of acute myocardial infarction. Cardiovasc Res 59:715–722CrossRefPubMed
25.
go back to reference Hale SL, Kloner RA (2002) Elevated body temperature during myocardial ischemia/reperfusion exacerbates necrosis and worsens no-reflow. Coron Artery Dis 13:177–181CrossRefPubMed Hale SL, Kloner RA (2002) Elevated body temperature during myocardial ischemia/reperfusion exacerbates necrosis and worsens no-reflow. Coron Artery Dis 13:177–181CrossRefPubMed
26.
go back to reference Hale SL, Kloner RA (1998) Myocardial temperature reduction attenuates necrosis after prolonged ischemia in rabbits. Cardiovasc Res 40:502–507CrossRefPubMed Hale SL, Kloner RA (1998) Myocardial temperature reduction attenuates necrosis after prolonged ischemia in rabbits. Cardiovasc Res 40:502–507CrossRefPubMed
27.
go back to reference Miki T, Liu GS, Cohen MV, Downey JM (1998) Mild hypothermia reduces infarct size in the beating rabbit heart: a practical intervention for acute myocardial infarction? Basic Res Cardiol 93:372–383CrossRefPubMed Miki T, Liu GS, Cohen MV, Downey JM (1998) Mild hypothermia reduces infarct size in the beating rabbit heart: a practical intervention for acute myocardial infarction? Basic Res Cardiol 93:372–383CrossRefPubMed
28.
go back to reference Hale SL, Dave RH, Kloner RA (1997) Regional hypothermia reduces myocardial necrosis even when instituted after the onset of ischemia. Basic Res Cardiol 92:351–357CrossRefPubMed Hale SL, Dave RH, Kloner RA (1997) Regional hypothermia reduces myocardial necrosis even when instituted after the onset of ischemia. Basic Res Cardiol 92:351–357CrossRefPubMed
29.
go back to reference Hale SL, Kloner RA (1997) Myocardial temperature in acute myocardial infarction: protection with mild regional hypothermia. Am J Physiol 273(1 Pt 2):H220–227PubMed Hale SL, Kloner RA (1997) Myocardial temperature in acute myocardial infarction: protection with mild regional hypothermia. Am J Physiol 273(1 Pt 2):H220–227PubMed
30.
go back to reference Dae MW, Gao DW, Sessler DI, Chair K, Stillson CA (2002) Effect of endovascular cooling on myocardial temperature, infarct size and cardiac output in human-sized pigs. Am J Physiol Heart Circ Physiol 282:H1584–1591PubMed Dae MW, Gao DW, Sessler DI, Chair K, Stillson CA (2002) Effect of endovascular cooling on myocardial temperature, infarct size and cardiac output in human-sized pigs. Am J Physiol Heart Circ Physiol 282:H1584–1591PubMed
31.
go back to reference Dixon SR, Whitbourn RJ, Dae MW, Grube E, Sherman W, Schaer GL, Jenkins JS, Baim DS, Gibbons RJ, Kuntz RE, Popma JJ, Nguyen TT, O’Neill WW (2002) Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. J Am Coll Cardiol 40:1928–1934CrossRefPubMed Dixon SR, Whitbourn RJ, Dae MW, Grube E, Sherman W, Schaer GL, Jenkins JS, Baim DS, Gibbons RJ, Kuntz RE, Popma JJ, Nguyen TT, O’Neill WW (2002) Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. J Am Coll Cardiol 40:1928–1934CrossRefPubMed
32.
go back to reference Valeri CR, Feingold H, Cassidy G, Ragno G, Khuri S, Altschule MD (1987) Hypothermia-induced reversible platelet dysfunction. Ann Surg 205:175–181PubMed Valeri CR, Feingold H, Cassidy G, Ragno G, Khuri S, Altschule MD (1987) Hypothermia-induced reversible platelet dysfunction. Ann Surg 205:175–181PubMed
33.
go back to reference Michelson AD, MacGregor H, Barnard MR, Kestin AS, Rohrer MJ, Valeri CR (1994) Hypothermia-induced reversible platelet dysfunction. Thromb Haemost 71:633–640PubMed Michelson AD, MacGregor H, Barnard MR, Kestin AS, Rohrer MJ, Valeri CR (1994) Hypothermia-induced reversible platelet dysfunction. Thromb Haemost 71:633–640PubMed
34.
go back to reference Watts DD, Trask A, Soeken K, Perdue P, Dols S, Kaufmann C (1998) Hypothermic coagulopathy in trauma: effect of varying levels of hypothermia on enzyme speed, platelet function and fibrinolytic activity. J Trauma 44:846–854PubMed Watts DD, Trask A, Soeken K, Perdue P, Dols S, Kaufmann C (1998) Hypothermic coagulopathy in trauma: effect of varying levels of hypothermia on enzyme speed, platelet function and fibrinolytic activity. J Trauma 44:846–854PubMed
35.
go back to reference Valeri CR, MacGregor H, Cassidy G, Tinney R, Pompei F (1995) Effects of temperature on bleeding time and clotting time in normal male and female volunteers. Crit Care Med 23:698–704CrossRefPubMed Valeri CR, MacGregor H, Cassidy G, Tinney R, Pompei F (1995) Effects of temperature on bleeding time and clotting time in normal male and female volunteers. Crit Care Med 23:698–704CrossRefPubMed
36.
go back to reference Patt A, McCroskey B, Moore E (1988) Hypothermia-induced coagulopathies in trauma (Review). Surg Clin North Am 68:775–785PubMed Patt A, McCroskey B, Moore E (1988) Hypothermia-induced coagulopathies in trauma (Review). Surg Clin North Am 68:775–785PubMed
37.
go back to reference Ferrara A, MacArthur JD, Wright HK, Modlin IM, McMillen MA (1990) Hypothermia and acidosis worsen coagulopathy in the patients requiring massive transfusion. Am J Surg 160:515–518PubMed Ferrara A, MacArthur JD, Wright HK, Modlin IM, McMillen MA (1990) Hypothermia and acidosis worsen coagulopathy in the patients requiring massive transfusion. Am J Surg 160:515–518PubMed
38.
go back to reference Reed RL, Bracey AW, Hudson JD, Miller TA, Fischer RP (1990) Hypothermia and blood coagulation: dissociation between enzyme activity and clotting factor levels. Circ Shock 32:141–152PubMed Reed RL, Bracey AW, Hudson JD, Miller TA, Fischer RP (1990) Hypothermia and blood coagulation: dissociation between enzyme activity and clotting factor levels. Circ Shock 32:141–152PubMed
39.
go back to reference Rohrer MJ, Natale AM (1992) Effect of hypothermia on the coagulation cascade. Crit Care Med 20:1402–1405PubMed Rohrer MJ, Natale AM (1992) Effect of hypothermia on the coagulation cascade. Crit Care Med 20:1402–1405PubMed
40.
go back to reference Resnick DK, Marion DW, Darby JM (1994) The effect of hypothermia on the incidence of delayed traumatic intracerebral hemorrhage. Neurosurgery 34:352–356 Resnick DK, Marion DW, Darby JM (1994) The effect of hypothermia on the incidence of delayed traumatic intracerebral hemorrhage. Neurosurgery 34:352–356
41.
go back to reference Jurkovich GJ, Greiser WB, Luterman A, Curreri PW (1987) Hypothermia in trauma victims: an ominous predictor of survival. J Trauma 27:1019–1024PubMed Jurkovich GJ, Greiser WB, Luterman A, Curreri PW (1987) Hypothermia in trauma victims: an ominous predictor of survival. J Trauma 27:1019–1024PubMed
42.
go back to reference Luna GK, Maier RV, Pavlin EG, Anardi D, Copass MK, Oreskovich MR (1987) Incidence and effect of hypothermia in seriously injured patients. J Trauma 27:1014–1018PubMed Luna GK, Maier RV, Pavlin EG, Anardi D, Copass MK, Oreskovich MR (1987) Incidence and effect of hypothermia in seriously injured patients. J Trauma 27:1014–1018PubMed
43.
go back to reference Gentilello LM, Jurkovich GJ, Stark MS, Hassantash SA, O’Keefe GE (1997) Is hypothermia in the victim of major trauma protective or harmful? Ann Surg 226:439–447CrossRefPubMed Gentilello LM, Jurkovich GJ, Stark MS, Hassantash SA, O’Keefe GE (1997) Is hypothermia in the victim of major trauma protective or harmful? Ann Surg 226:439–447CrossRefPubMed
44.
go back to reference Tisherman SA, Rodriguez A, Safar P (1999) Trauma care in the new millennium. Therapeutic hypothermia in traumatology. Surg Clin North Am 79:1269–1289PubMed Tisherman SA, Rodriguez A, Safar P (1999) Trauma care in the new millennium. Therapeutic hypothermia in traumatology. Surg Clin North Am 79:1269–1289PubMed
45.
go back to reference Steinemann S, Shackford SR, Davis JW (1990) Implications of admission hypothermia in trauma patients. J Trauma 30:200–202PubMed Steinemann S, Shackford SR, Davis JW (1990) Implications of admission hypothermia in trauma patients. J Trauma 30:200–202PubMed
46.
go back to reference Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR, Muizelaar JP, Wagner FC, Marion DW, Luerssen TG, Chesnut RM, Schwartz M (2001) Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 344:556–563PubMed Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR, Muizelaar JP, Wagner FC, Marion DW, Luerssen TG, Chesnut RM, Schwartz M (2001) Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 344:556–563PubMed
47.
go back to reference Salman H, Bergman M, Bessler H, Alexandrova S, Beilin B, Djaldetti M (2000) Hypothermia affects the phagocytic activity of rat peritoneal macrophages. Acta Physiol Scand 168:431–436CrossRefPubMed Salman H, Bergman M, Bessler H, Alexandrova S, Beilin B, Djaldetti M (2000) Hypothermia affects the phagocytic activity of rat peritoneal macrophages. Acta Physiol Scand 168:431–436CrossRefPubMed
48.
go back to reference Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S, Nakamori Y, Tanaka H, Shimazu T, Sugimoto H (2001) A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. J Neurosurg 94:50–54PubMed Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S, Nakamori Y, Tanaka H, Shimazu T, Sugimoto H (2001) A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. J Neurosurg 94:50–54PubMed
49.
go back to reference Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA (2001) Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke 32:2033–2035PubMed Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA (2001) Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke 32:2033–2035PubMed
50.
go back to reference Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, Wisniewski SR, DeKosky ST (1997) Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 336:540–546PubMed Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, Wisniewski SR, DeKosky ST (1997) Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 336:540–546PubMed
51.
go back to reference Polderman KH, Tjong Tjin Joe R, Peerdeman SM, Vandertop WP, Girbes ARJ (2002) Effects of artificially induced hypothermia on intracranial pressure and outcome in patients with severe traumatic head injury. Intensive Care Med 28:1563-1567CrossRef Polderman KH, Tjong Tjin Joe R, Peerdeman SM, Vandertop WP, Girbes ARJ (2002) Effects of artificially induced hypothermia on intracranial pressure and outcome in patients with severe traumatic head injury. Intensive Care Med 28:1563-1567CrossRef
52.
go back to reference Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563PubMed Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563PubMed
53.
go back to reference The Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556PubMed The Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556PubMed
54.
go back to reference Kurz A, Sessler DI, Lenhardt R and the Study of Wound Infection and Temperature Group (1996) Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. New Engl J Med 334:1209–1215CrossRefPubMed Kurz A, Sessler DI, Lenhardt R and the Study of Wound Infection and Temperature Group (1996) Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. New Engl J Med 334:1209–1215CrossRefPubMed
55.
56.
go back to reference Sheffield CW, Sessler DI, Hunt TK (1994) Mild hypothermia during isoflurane anesthesia decreases resistance to E. Coli dermal infection in guinea pigs. Acta Anesthesiol Scand 38:201–205 Sheffield CW, Sessler DI, Hunt TK (1994) Mild hypothermia during isoflurane anesthesia decreases resistance to E. Coli dermal infection in guinea pigs. Acta Anesthesiol Scand 38:201–205
57.
go back to reference Sheffield CW, Sessler DI, Hunt TK, Scheuenstuhl H (1994) Mild hypothermia during halothane anesthesia decreases resistance to S. Aureus dermal infection in guinea pigs. Wound Rep Reg 2:48–56CrossRef Sheffield CW, Sessler DI, Hunt TK, Scheuenstuhl H (1994) Mild hypothermia during halothane anesthesia decreases resistance to S. Aureus dermal infection in guinea pigs. Wound Rep Reg 2:48–56CrossRef
58.
go back to reference Polderman KH, Girbes ARJ, Peerdeman SM, Vandertop WP (2001) Hypothermia (review/comment). J Neurosurgery 94:853–855 Polderman KH, Girbes ARJ, Peerdeman SM, Vandertop WP (2001) Hypothermia (review/comment). J Neurosurgery 94:853–855
59.
go back to reference Polderman KH, Peerdeman SM, Girbes ARJ (2001) Hypophosphatemia and hypomagnesemia induced by cooling in patients with severe head injury. Journal of Neurosurg 94:697–705 Polderman KH, Peerdeman SM, Girbes ARJ (2001) Hypophosphatemia and hypomagnesemia induced by cooling in patients with severe head injury. Journal of Neurosurg 94:697–705
60.
go back to reference Kaufman HH, Timberlake G, Voelker J, Pait TG (1993) Medical complications of head injury. Med Clin North Am 77:43–60PubMed Kaufman HH, Timberlake G, Voelker J, Pait TG (1993) Medical complications of head injury. Med Clin North Am 77:43–60PubMed
61.
62.
go back to reference The Brain Trauma Foundation. The American Association of Neurological Surgeons (2000) The Joint Section on Neurotrauma and Critical Care. Guidelines for cerebral perfusion pressure. J Neurotrauma 17:507–511PubMed The Brain Trauma Foundation. The American Association of Neurological Surgeons (2000) The Joint Section on Neurotrauma and Critical Care. Guidelines for cerebral perfusion pressure. J Neurotrauma 17:507–511PubMed
63.
go back to reference Fearnside MR, Cook RJ, McDougall P, McNeil RJ (1993) The Westmead Head Injury Project outcome in severe head injury. A comparative analysis of pre-hospital, clinical and CT variables. Br J Neurosurg 7:267–279PubMed Fearnside MR, Cook RJ, McDougall P, McNeil RJ (1993) The Westmead Head Injury Project outcome in severe head injury. A comparative analysis of pre-hospital, clinical and CT variables. Br J Neurosurg 7:267–279PubMed
64.
go back to reference Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF (1993) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl (Wien) 59:121–125 Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF (1993) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl (Wien) 59:121–125
65.
go back to reference Polderman KH, Sterz F, van Zanten ARH, Uray T, Losert H, de Waal R, Girbes ARJ, Holzer M (2003) Induced hypothermia improves neurological outcome in asystolic patients with out-of hospital cardiac arrest (abstract). Circulation 108:IV-581 [abstract 2646] Polderman KH, Sterz F, van Zanten ARH, Uray T, Losert H, de Waal R, Girbes ARJ, Holzer M (2003) Induced hypothermia improves neurological outcome in asystolic patients with out-of hospital cardiac arrest (abstract). Circulation 108:IV-581 [abstract 2646]
66.
go back to reference Aibiki M, Kawaguchi S, Maekawa N (2001) Reversible hypophosphatemia during moderate hypothermia therapy for brain-injured patients. Crit Care Med 29:1726–1730PubMed Aibiki M, Kawaguchi S, Maekawa N (2001) Reversible hypophosphatemia during moderate hypothermia therapy for brain-injured patients. Crit Care Med 29:1726–1730PubMed
67.
go back to reference McIntosh TK Vink R, Yamakami I, Faden AI (1989) Magnesium protects against neurological deficit after brain injury. Brain Res 482:252–260PubMed McIntosh TK Vink R, Yamakami I, Faden AI (1989) Magnesium protects against neurological deficit after brain injury. Brain Res 482:252–260PubMed
68.
go back to reference Vink R (1988) Decline in intracellular free Mg2+ is associated with irreversible tissue injury after brain trauma. J Biol Chem 263:757–761PubMed Vink R (1988) Decline in intracellular free Mg2+ is associated with irreversible tissue injury after brain trauma. J Biol Chem 263:757–761PubMed
69.
go back to reference Vink R, Cernak I (2000) Regulation of intracellular free magnesium in central nervous system injury. Front Biosci 5:656–665 Vink R, Cernak I (2000) Regulation of intracellular free magnesium in central nervous system injury. Front Biosci 5:656–665
70.
go back to reference Polderman KH, Zanten ARH van, Girbes ARJ (2003) The importance of magnesium in critically ill patients: a role in mitigating neurological injury and in the prevention of vasospasms. Intensive Care Med 29:1202–1203CrossRefPubMed Polderman KH, Zanten ARH van, Girbes ARJ (2003) The importance of magnesium in critically ill patients: a role in mitigating neurological injury and in the prevention of vasospasms. Intensive Care Med 29:1202–1203CrossRefPubMed
71.
go back to reference Polderman KH, Bloemers F, Peerdeman SM, Girbes ARJ (2000) Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit Care Med 28:2022–2025 Polderman KH, Bloemers F, Peerdeman SM, Girbes ARJ (2000) Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit Care Med 28:2022–2025
72.
go back to reference Dietrich WD, Alonso O, Busto R, Globus MYT, Ginsberg MD (1994) Posttraumatic brain hypothermia reduces histopathological damage following concussive brain injury in the rat. Acta Neuropathol 87:250–258PubMed Dietrich WD, Alonso O, Busto R, Globus MYT, Ginsberg MD (1994) Posttraumatic brain hypothermia reduces histopathological damage following concussive brain injury in the rat. Acta Neuropathol 87:250–258PubMed
73.
go back to reference Vacanti FX, Ames AA (1983) Mild hypothermia and Mg++ protect against irreversible damage during CNS ischemia. Stroke 15:695–698 Vacanti FX, Ames AA (1983) Mild hypothermia and Mg++ protect against irreversible damage during CNS ischemia. Stroke 15:695–698
74.
go back to reference Saatman KE, Bareyre FM, Grady MS, McIntosh TK (2001) Acute cytoskeletal alterations and cell death induced by experimental brain injury are attenuated by magnesium treatment and exacerbated by magnesium deficiency. J Neuropathol Exp Neurol 60:183–194 Saatman KE, Bareyre FM, Grady MS, McIntosh TK (2001) Acute cytoskeletal alterations and cell death induced by experimental brain injury are attenuated by magnesium treatment and exacerbated by magnesium deficiency. J Neuropathol Exp Neurol 60:183–194
75.
go back to reference Bareyre FM, Saatman KE, Raghupathi R, McIntosh TH (2000) Postinjury treatment with magnesium chloride attenuates cortical damage after traumatic brain injury in rats. J. Neurotrauma 17:1029–1039PubMed Bareyre FM, Saatman KE, Raghupathi R, McIntosh TH (2000) Postinjury treatment with magnesium chloride attenuates cortical damage after traumatic brain injury in rats. J. Neurotrauma 17:1029–1039PubMed
76.
go back to reference Garcia LA, Dejong SC, Martin SM, Smith RS, Buettner GR, Kerber RE (1998) Magnesium reduces free radicals in an in vivo coronary occlusion-reperfusion model. J Am Coll Cardiol 32:536–539CrossRefPubMed Garcia LA, Dejong SC, Martin SM, Smith RS, Buettner GR, Kerber RE (1998) Magnesium reduces free radicals in an in vivo coronary occlusion-reperfusion model. J Am Coll Cardiol 32:536–539CrossRefPubMed
77.
go back to reference Pyne GJ, Cadoux-Hudson TA, Clark JF (2001) Magnesium protection against in vitro cerebral vasospasm after subarachnoid haemorrhage. Br J Neurosurg 15:409–415CrossRefPubMed Pyne GJ, Cadoux-Hudson TA, Clark JF (2001) Magnesium protection against in vitro cerebral vasospasm after subarachnoid haemorrhage. Br J Neurosurg 15:409–415CrossRefPubMed
78.
go back to reference Teragawa H, Kato M, Yamagata T, Matsuura H, Kajiyama G (2000)The preventive effect of magnesium on coronary spasm in patients with vasospastic angina. Chest 118:1690–1695PubMed Teragawa H, Kato M, Yamagata T, Matsuura H, Kajiyama G (2000)The preventive effect of magnesium on coronary spasm in patients with vasospastic angina. Chest 118:1690–1695PubMed
80.
go back to reference Rubeiz GJ, Thill-Baharozian M, Hardie D, Carlson RW (1993) Association of hypomagnesemia and mortality in acutely ill medical patients. Crit Care Med 21:203–209PubMed Rubeiz GJ, Thill-Baharozian M, Hardie D, Carlson RW (1993) Association of hypomagnesemia and mortality in acutely ill medical patients. Crit Care Med 21:203–209PubMed
81.
go back to reference Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in critically ill patients. New Engl J Med 345:1359–1367PubMed Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in critically ill patients. New Engl J Med 345:1359–1367PubMed
82.
go back to reference Van den Berghe G, Wouters PJ, Bouillon R, Weekers F, Verwaest C, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P (2003) Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med 31:359–366PubMed Van den Berghe G, Wouters PJ, Bouillon R, Weekers F, Verwaest C, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P (2003) Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med 31:359–366PubMed
83.
go back to reference Finney SJ, Zekveld C, Elia A, Evans TW (2003) Glucose control and mortality in critically ill patients. JAMA 290:2041–2047CrossRefPubMed Finney SJ, Zekveld C, Elia A, Evans TW (2003) Glucose control and mortality in critically ill patients. JAMA 290:2041–2047CrossRefPubMed
84.
go back to reference Connolly J, Boyd R, Calvin J (1962) The protective effect of hypothermia in cerebral ischemia: experimental and clinical application by selective brain cooling in the human. Surgery 52:15–24PubMed Connolly J, Boyd R, Calvin J (1962) The protective effect of hypothermia in cerebral ischemia: experimental and clinical application by selective brain cooling in the human. Surgery 52:15–24PubMed
85.
go back to reference Schwartz AE, Stone JG, Finck AD, Sandhu AA, Mongero LB, Adams DC, Jonassen AE, Young WL, Michler RE (1996) Isolated cerebral hypothermia by single carotid artery perfusion of extracorporeally cooled blood in baboons. Neurosurgery 39:577–581PubMed Schwartz AE, Stone JG, Finck AD, Sandhu AA, Mongero LB, Adams DC, Jonassen AE, Young WL, Michler RE (1996) Isolated cerebral hypothermia by single carotid artery perfusion of extracorporeally cooled blood in baboons. Neurosurgery 39:577–581PubMed
86.
go back to reference Gelman B, Schleien CL, Lohe A, Kuluz JW (1996) Selective brain cooling in infant piglets after cardiac arrest and resuscitation. Crit Care Med 24:1009–1017CrossRefPubMed Gelman B, Schleien CL, Lohe A, Kuluz JW (1996) Selective brain cooling in infant piglets after cardiac arrest and resuscitation. Crit Care Med 24:1009–1017CrossRefPubMed
87.
go back to reference Natale JA, D’Alecy LG (1989) Protection from cerebral ischemia by brain cooling without reduced lactate accumulation in dogs. Stroke 20:770–777PubMed Natale JA, D’Alecy LG (1989) Protection from cerebral ischemia by brain cooling without reduced lactate accumulation in dogs. Stroke 20:770–777PubMed
88.
go back to reference Xiao F, Safar P, Alexander H (1995) Peritoneal cooling for mild cerebral hypothermia after cardiac arrest in dogs. Resuscitation 30:51–59CrossRefPubMed Xiao F, Safar P, Alexander H (1995) Peritoneal cooling for mild cerebral hypothermia after cardiac arrest in dogs. Resuscitation 30:51–59CrossRefPubMed
89.
go back to reference O’Donnel J, Axelrod P, Fisher C, Lorber B (1997) Use and effectiveness of hypothermia blankets for febrile patients in the intensive care unit. Clin Infect Dis 24:1208–1213PubMed O’Donnel J, Axelrod P, Fisher C, Lorber B (1997) Use and effectiveness of hypothermia blankets for febrile patients in the intensive care unit. Clin Infect Dis 24:1208–1213PubMed
90.
go back to reference Georgiadis D, Schwarz S, Kollmar R, Schwab S (2001) Endovascular cooling for moderate hypothermia in patients with acute stroke. Stroke 32:2550–2553PubMed Georgiadis D, Schwarz S, Kollmar R, Schwab S (2001) Endovascular cooling for moderate hypothermia in patients with acute stroke. Stroke 32:2550–2553PubMed
91.
go back to reference Doufas AG, Akca O, Barry A, petrusca DA, Suleman MI, Morioka N, Guarnaschelli JJ, Sessler DI (2002) Initial experience with a novel heat-exchanging catheter in neurosurgical patients. Anesth Analg 95:1752–1756PubMed Doufas AG, Akca O, Barry A, petrusca DA, Suleman MI, Morioka N, Guarnaschelli JJ, Sessler DI (2002) Initial experience with a novel heat-exchanging catheter in neurosurgical patients. Anesth Analg 95:1752–1756PubMed
92.
go back to reference Schmutzhard E, Engelhardt K, Beer R, Brössner G, Pfausler B, Spiss H, Unterberger I, Kampfl A (2002) Safety and efficacy of a novel intravascular cooling device to control body temperature in neurologic intensive care patients: a prospective pilot study. Crit Care Med 30:2481–2488CrossRefPubMed Schmutzhard E, Engelhardt K, Beer R, Brössner G, Pfausler B, Spiss H, Unterberger I, Kampfl A (2002) Safety and efficacy of a novel intravascular cooling device to control body temperature in neurologic intensive care patients: a prospective pilot study. Crit Care Med 30:2481–2488CrossRefPubMed
93.
go back to reference Andrews PJD, Harris BA (2002) The rationale for selective brain cooling. Year book of intensive care and emergency medicine. Vincent JL (ed) Springer Verlag, Berlin Heidelbrg New York, pp 738–747 Andrews PJD, Harris BA (2002) The rationale for selective brain cooling. Year book of intensive care and emergency medicine. Vincent JL (ed) Springer Verlag, Berlin Heidelbrg New York, pp 738–747
94.
go back to reference Mayer SA, Commichau C, Scarmeas N, Presciutti M, Bates J, Copeland D (2000) Clinical trial of an air-circulating cooling blanket for fever control in critically ill neurologic patients. Neurology 56:292–298 Mayer SA, Commichau C, Scarmeas N, Presciutti M, Bates J, Copeland D (2000) Clinical trial of an air-circulating cooling blanket for fever control in critically ill neurologic patients. Neurology 56:292–298
95.
go back to reference Kammersgaard LP, Rasmussen BH, Jørgensen HS, Reith J, Weber U, Olsen TS (2000) Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: a case-control study: the Copenhagen Stroke Study. Stroke 31:2251–2256PubMed Kammersgaard LP, Rasmussen BH, Jørgensen HS, Reith J, Weber U, Olsen TS (2000) Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: a case-control study: the Copenhagen Stroke Study. Stroke 31:2251–2256PubMed
96.
go back to reference Bernard S, Buist M, Monteiro O, Smith K (2003) Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 56:9–13CrossRefPubMed Bernard S, Buist M, Monteiro O, Smith K (2003) Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 56:9–13CrossRefPubMed
97.
go back to reference Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ (2000) Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit. Lancet 356:185–189PubMed Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ (2000) Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit. Lancet 356:185–189PubMed
Metadata
Title
Application of therapeutic hypothermia in the intensive care unit
Opportunities and pitfalls of a promising treatment modality—Part 2: Practical aspects and side effects
Author
Kees H. Polderman
Publication date
01-05-2004
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 5/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2151-y

Other articles of this Issue 5/2004

Intensive Care Medicine 5/2004 Go to the issue