The use of controlled mild hypothermia and immune system status in patients with severe brain injury.
BACKGROUND
Severe brain injuries pose one of the most important problems on our health care because of their high morbidity and mortality.


METHODS
A group of 89 patients after severe brain injury (Glasgow Coma Scale< or =8) was included into our research of detecting the changes of immune system parameters and their relation to the application of mild hypothermia during the early period after the insult.


RESULTS
In both of the groups CD3+ and CD4+ lymphocytic levels decreased significantly after the insult and gradually got to normal (p<0.01). The NK cells levels have changed in correlation with the course of infection. Immunoglobulin (IgA, IgG) levels were normal or slightly increased. IgM levels changes had a close relation to the occurrence of inflammatory complications, especially that of pneumonia (p<0.01). The most surprising moment in our research was the level of IgE antibodies. They had been high and got even higher. They achieved the values typical for atopic reactions or parasitic diseases. 77.52 % of the patients with decreased parameters of immune system developed extra cranial complications. Immune system disorders appeared more frequently in the patients with lower Glasgow Coma Scale after admission (p<0.01). The application of mild hypothermia caused an unimportant increase in extra cranial complications (p>0.05) having no relation to immunity disorders.


CONCLUSIONS
Intensive treatment of intracranial hypertension fundamentally affects results of our treatment (Glasgow Outcome Score). The application of controlled mild hypothermia doesn't escalate the occurrence of extra cranial inflammatory complications after severe brain injury (Tab. 2, Fig. 11, Ref. 15).
Mrlian
A
A
Department of Neurosurgery, University Hospital Brno, Czech Republic. andrejmrlian@hotmail.com
Smrcka
M
M
Klabusay
M
M
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000276:immunology / Q000628:therapy*; D017252:CD3 Complex / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis; D006801:Humans; D007036:Hypothermia, Induced; D007136:Immunoglobulins / Q000097:blood; D008875:Middle Aged
D017252:CD3 Complex; D015704:CD4 Antigens; D007136:Immunoglobulins