Therapeutic Hypothermia Reduces Intracranial Pressure and Partial Brain @entity26 Tension in @entity1 with Severe XXXX : Preliminary Data from the Eurotherm3235 Trial.

@entity1545 @entity1 @entity131 @entity101 @entity2332 @entity63 @entity428 @entity26 @entity519 @entity204 @entity130
@entity131 ( @entity131 ) is a significant cause of disability and @entity204 and a huge economic burden throughout the world. Much of the morbidity associated with @entity131 is attributed to secondary @entity1545 resulting in @entity519 and @entity63 after the initial @entity130 . Intracranial @entity101 and decreased partial brain @entity26 tension (PbtO2) are targeted as potentially avoidable causes of morbidity. @entity2332 ( @entity2332 ) may be an effective intervention to reduce @entity428 ( @entity428 ), but could also affect cerebral blood flow (CBF). This is a retrospective analysis of prospectively collected data from 17 @entity1 admitted to the Western General Hospital, Edinburgh. @entity1 with an @entity428 >20   mmHg refractory to initial therapy were randomized to standard care or standard care and @entity2332 (intervention group) titrated between 32  C and 35  C to reduce @entity428 . @entity428 and PbtO2 were measured using the Licox system and core temperature was recorded through rectal thermometer. Data were analyzed at the hour before cooling, the first hour at target temperature, 2 consecutive hours at target temperature, and after 6 hours of @entity2332 . There was a mean decrease in @entity428 of 4.3  1.6   mmHg (p<0.04) from 15.7 to 11.4   mmHg, from precooling to the first epoch of @entity2332 in the intervention group (n=9) that was not seen in the control group (n=8). A decrease in @entity428 was maintained throughout all time periods. There was a mean decrease in PbtO2 of 7.8  3.1   mmHg (p<0.05) from 30.2 to 22.4   mmHg, from precooling to stable @entity2332 , which was not seen in the control group. This research supports others in demonstrating a decrease in @entity428 with temperature, which could facilitate a reduction in the use of hyperosmolar agents or other stage II interventions. The decrease in PbtO2 is not below the suggested treatment threshold of 20   mmHg, but might indicate a decrease in CBF.
