[Clinical analysis of hypothermia in children with severe head injury].
Therapeutic hypothermia may improve outcome after severe head injury, but its efficacy has not been established in children with a severe head injury. The authors evaluated the effects of hypothemia (33-34 degrees C) in 9 severely closed head-injured children (under 16 years old). The cooling period was 3 to 21 days (mean 9.3). Hypothermia significantly reduced ICP when it reached 33-34 degrees C. From 3 to 6 months after injury, 6 (67%) of the 9 patients had good outcome (good recovery in 2 and moderate disability in 4), but 3 (33%) had poor outcome (severe disability in 2 and vegetative state in one). Complications, including infectious disorders (pneumonia, meningitis, sepsis), cardio-vascular system dysfunction (cardiac arrhythmia, hypotension), decreased platelet counts, hypokalemia, diabetes insipidus, acute pancreatitis occurred during hypothermia in 7 patients (78%). The results of this study suggest that treatment with hypothermia in children with severe head injury is often accompanied complications, but it is an effective method to control intracranial hypertension and may have improved the outcome.
Takahashi
I
I
Department of Emergency, Teine Keijinkai Hospital, 12 chome 355, Maeda 1 jo, Teine-ku, Sapporo 006-8555, Japan.
Kitahara
T
T
Endo
M
M
Ohwada
T
T
D000293:Adolescent; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007427:Intracranial Pressure; D008297:Male; D008991:Monitoring, Physiologic; D011379:Prognosis; D012189:Retrospective Studies