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Therapeutic Hypothermia

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

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  1. Therapeutic Hypothermia Bryan Imayanagita 12/2/11 UCI T-RAP

  2. Background • Protective hypothermia • Reduce ischemic injury to tissue • Invasive and non invasive treatments • Can reduce ischemic brain injuries

  3. Categories of Treatment • Hypothermia therapy for neonatal encephalopathy • Cardiac arrest • Stroke • TBI/spinal cord injury • Neurogenic Fever

  4. 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

  5. Invasive: cooling catheters NS through femoral vein Control unit to bring down temperature (very accurate) complications Bleeding Infection DVT Invasive Treatment

  6. Non Invasive Treatment • Cold water blanket, torso vest, leg wraps • Can overshoot or undershoot target temperature

  7. 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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