Hypothermie thérapeutique en traumatologie crânienne grave

Translated title of the contribution: Therapeutic hypothermia for severe traumatic brain injury

P. Bouzat, G. Francony, M. Oddo, J. F. Payen

Research output: Contribution to journalShort surveypeer-review

Abstract

Therapeutic hypothermia (TH) is considered a standard of care in the post-resuscitation phase of cardiac arrest. In experimental models of traumatic brain injury (TBI), TH was found to have neuroprotective properties. However, TH failed to demonstrate beneficial effects on neurological outcome in patients with TBI. The absence of benefits of TH uniformly applied in TBI patients should not question the use of TH as a second-tier therapy to treat elevated intracranial pressure. The management of all the practical aspects of TH is a key factor to avoid side effects and to optimize the potential benefit of TH in the treatment of intracranial hypertension. Induction of TH can be achieved with external surface cooling or with intra-vascular devices. The therapeutic target should be set at a 35. °C using brain temperature as reference, and should be maintained at least during 48. hours and ideally over the entire period of elevated intracranial pressure. The control of the rewarming phase is crucial to avoid temperature overshooting and should not exceed 1. °C/day. Besides its use in the management of intracranial hypertension, therapeutic cooling is also essential to treat hyperthermia in brain-injured patients. In this review, we will discuss the benefit-risk balance and practical aspects of therapeutic temperature management in TBI patients.

Translated title of the contributionTherapeutic hypothermia for severe traumatic brain injury
Original languageFrench
Pages (from-to)787-791
Number of pages5
JournalAnnales francaises d'anesthesie et de reanimation
Volume32
Issue number11
DOIs
StatePublished - Nov 1 2013

Keywords

  • Injury
  • Intracranial pressure
  • Neuroprotection
  • Therapeutic hypothermia
  • Traumatic brain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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