Mild hypothermia patient selection

Shiozaki T., Sugimoto H., Taneda M., et al. (1998) Selection of severely head injured patients for mild hypothermia therapy. J. Neurosurg. 89, 206-211. 

PATIENT SELECTION FOR TREATMENT WITH MILD HYPOTHERMIA... 

Patients must be carefully screened and selected for treatment. Because hypothermia may potentiate bleeding disorders, coagulopathic patients should be excluded from this treatment. Routine coagulation studies are done before the body temperature is lowered. Patients with cryoglobulinopathies are also excluded, as hypothermia increases the risk for sickling of the cells. Mild hypothermia should be used cautiously in patients at high risk for infection. 

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... 

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