The use of intravascular hypothermia to correct intracranial hypertension in patients with severe traumatic brain injury

Oshorov A.V.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

SPIN RSCI: 6630-6008
Scopus AuthorID: 24478016900
ORCID: 0000-0002-3674-252X

Popugaev K.A.

N.V. Sklifosovsky Research Institute of Emergency Care, Moscow, Russia

ORCID: 0000-0002-6240-820X

Savin I.A.

Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia

SPIN RSCI: 1342-7065
Scopus AuthorID: 35974373500
ORCID: 0000-0003-3874-4147

Lubnin A.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia, N.N. Burdenko Research Institute of Neurosurgery, Moscow, Russia, Department of Obstetrics and Gynecology, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia

RSCI AuthorID: 370609
Scopus AuthorID: 57192157123
ORCID: 0000-0003-2595-5877

Gavrilov A.G.

N.N. Burdenko Institute of Neurosurgery, Moscow, Russia

Likhterman L.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kravchuk A.D.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Potapov A.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

The use of intravascular hypothermia to correct intracranial hypertension in patients with severe traumatic brain injury

Authors:

Oshorov A.V., Popugaev K.A., Savin I.A., Lubnin A.Yu., Gavrilov A.G., Likhterman L.B., Kravchuk A.D., Potapov A.A.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2014;78(5): 41‑48

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To cite this article:

Oshorov AV, Popugaev KA, Savin IA, et al. . The use of intravascular hypothermia to correct intracranial hypertension in patients with severe traumatic brain injury. Burdenko's Journal of Neurosurgery. 2014;78(5):41‑48. (In Russ., In Engl.)

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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Objective: Assess to impact hypothermia on ABP, CPP, ICP and cerebral autoregulation. Material and methods. 14 patients with TBI (GOS<9) underwent hypothermia by Thermogard system within 32-35 °C (Zoll, USA). ICP was measured intraparenchymal by Codman sensor. Cerebral autoregulation was estimated by correlation coefficient Prx (Soft ICM Plus, Cambridge, UK). Temperature was measured in urinary bladder. There were selected five time periods: 1 - phase of initial state, 2 - phase of induction hypothermia, 3 - phase of hypothermia, 4 - phase of rewarming, 5 - phase after finishing hypothermia. All data preset as Mediana (min; max). Stat analysis was perfomed using Soft Statistica 10.0. Results. Phase 1 lasted nearly 7 (2; 12) h, ABP 94 (81; 102), CPP - 73 (52; 87), ICP 27 (16; 45) mm Hg, Prx 0,25 (-0,15; 0,7), temperature 38,2 °C (37; 39,8). Phase 2: 5 (2; 12) h, ABP 95 (85; 114), CPP 80 (65; 96), ICP 18 (10; 22) mm Hg, Prx -0,055 (-0,15; 0,7), temperature 35,2 °C (34,5; 35,5). Phase 3: 55 (20; 100) h, there were not significant changed ABP, CPP, Prx, ICP 15 (10; 18) mm Hg, temperature was 33,5 °C (32; 34,7). Phase 4: 17 (8; 24) h, ABP 90 (70; 100), CPP 77 (55; 85), ICP 15 (9; 27) mm Hg and Prx 0,2 (-0,2; 0,32). Temperature 36,9 °C (35,9; 38,5). Phase 5: 20 (6; 240) h, ABP 87(53; 110), CPP 72 (47; 107), ICP 17 (10; 32) mm Hg and Prx 0,2 (-0,2; 0,6). Temperature 37,7 °C (36,7; 39,0). Conclusion. Hypothermia is an effective method for correction of intracranial hypertension. Hypothermia can use as a additional option of intensive care during refractory intracranial hypertension. Rewarming phase is the most dangerous time on the re-development of intracranial hypertension and disruption of autoregulation.

Keywords:

intravascular hyperthermia

intravascular hypertension

Thermogard system

autoregulation coefficient Prx

Authors:

Oshorov A.V.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

SPIN RSCI: 6630-6008
Scopus AuthorID: 24478016900
ORCID: 0000-0002-3674-252X

Popugaev K.A.

N.V. Sklifosovsky Research Institute of Emergency Care, Moscow, Russia

ORCID: 0000-0002-6240-820X

Savin I.A.

SPIN RSCI: 1342-7065
Scopus AuthorID: 35974373500
ORCID: 0000-0003-3874-4147

Lubnin A.Yu.

RSCI AuthorID: 370609
Scopus AuthorID: 57192157123
ORCID: 0000-0003-2595-5877

Gavrilov A.G.

N.N. Burdenko Institute of Neurosurgery, Moscow, Russia

Likhterman L.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kravchuk A.D.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Potapov A.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

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