Hypothermia head injuries

Alcohol is a common cause of coma in all age ranges. Coma depth and length is associated with the amount of alcohol ingested, and this shows wide inter-paiiem variation. Alcoholic coma can be associated with head injuries, hypothermia and the presence of other drugs with which its action may be additive. In most cases, coma caused by ethanol will resolve relatively rapidly, the exception being when there is hepatic insufficiency. In cases where the blood alcohol level exceeds 80 mmol/l. haemodialysis may be required. The fact that alcohol can... 

Piepgras A., Roth H., Schurer L., et al. (1998) Rapid active internal core cooling for induction of moderate hypothermia in head injury by use of an extracorporeal heat exchanger. Neurosurgery 42, 311-317 discussion 317-318. 

Shiozaki T., Sugimoto H., Taneda M., et al. (1993) Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury. J. Neurosurg. 79, 363-368. 

Gadkary C. S., Alderson P., and Signorini D. F. (2002) Therapeutic hypothermia for head injury. Cochrane Database Syst. Rev. CD001048. 

Soukup J., Zauner A., Doppenberg E. M., et al. (2002) Relationship between brain temperature, brain chemistry and oxygen delivery after severe human head injury the effect of mild hypothermia. Neurol. Res. 24, 161-168. 

Marion D. W., ObristW. D., CarlierP. M., Penrod L. E., and Darby J. M. (1993) The use of moderate therapeutic hypothermia for patients with severe head injuries a preliminary report. J. Neurosurg. 79, 354-362. 

Hypothermia in stroke and head-injured patients is started as soon as possible after injury, and continues for the duration selected by the investigator. Each patient undergoing treatment with mild hypothermia should be paralyzed and sedated to prevent discomfort and reduce shivering. Unfortunately, this can compromise accurate evaluation of the neurological status in patients with acute head injury or stroke. Therefore, continuous monitoring of ICP is important in these intensive care unit patients. Because these patients are paralyzed and sedated, continuous mechanical ventilation is also necessary. Neuromuscular blocking... 

In protocols for stroke or head injury, normalizing the room temperature and halting all methods of hypothermia accomplished passive rewarming. Normothermia under these conditions is typically accomplished over 12-16 h (31,34,39). 

Extravasation of polymorphonuclear leukocytes (PMNs) in the area of injury occurs very early after injury in several different models of experimental TBI, and has been shown to correlate with the development of cerebral edema (101,102). Early canine studies conducted by Rosomoff (16,57) demonstrated that treatment with hypothermia decreased the posttraumatic cellular inflammatory response incited by experimental head injury compared to normothermic controls. This effect of hypothermia is likely mediated by several mechanisms including preservation of the BBB, thereby limiting extravasation of inflammatory cells and mediators into the area of injury (103), suppressing release of cytokines (22), and reducing CBF. 

Hendrick E. B. (1959) The use of hypothermia in severe head injuries in childhood. 

SedzimirC. B. (1959) Therapeutic hypothermia in cases of head injury. J. Neurosurg. 16,407 -14. 

Metz C., Holzschuh M., Bein T., et al. (1996) Moderate hypothermia in patients with severe head injury cerebral and extracerebral effects. J. Neurosurg. 85, 533-541. 

Psychiatric nurses and psychiatrists are particularly well suited as members of the medical team, as they can also be alert to organic mental disorders caused by conditions such as head injuries, toxic exposures, preexisting illnesses, dehydration, or hyper-/hypothermia. Because nurses have a tradition of practice in homes, in schools, and other natural settings, they tend to be readily accepted by members of the community. Agencies and staff that will be activated for counseling and... 

Ishikawa K, Tanaka H, Takaoka M, et al. Granulocyte colony-stimulating factor ameliorates life-threatening infections after combined therapy with barbiturates and mild hypothermia in patients with severe head injuries. J Trauma 1999 46 999-1007. 

Clifton G. L., Choi S. C., Miller E. R., et al. (2001) Intercenter variance in clinical trials of head trauma—experience of the National Acute Brain Injury Study Hypothermia. J. Neurosurg. 95,751-755. 

As slated before, hypothermia and other cold injuries can be prevented wearing sufScient winter clothing including head protection, gloves, mittens, and insulated... 

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