Regional cooling for reducing brain temperature and intracranial pressure.
OBJECTIVE
To evaluate the effectiveness of regional cooling for reducing brain temperature (BrTe) and intracranial pressure (ICP) in patients where conventional clinical treatment has failed.


METHODS
Regional cooling was carried out using ice bags covering the area of the craniectomy (regional method) in 23 patients. The BrTe and ICP were determined using a fiber optic sensor. Thirteen patients (56.52%) were female. The ages ranged from 16 to 83 years (mean of 48.9). The mean APACHE II score was 25 points (11-35). The patients were submitted, on mean, to 61.7 hours (20-96) of regional cooling.


RESULTS
There was a significant reduction in mean BrTe (p<0.0001--from 37.1 degrees C to 35.2 degrees C) and mean ICP (p=0.0001--from 28 mmHg to 13 mmHg).


CONCLUSIONS
Our results suggest that mild brain hypothermia induced by regional cooling was effective in the control of ICP in patients who had previously undergone decompressive craniectomy.
Forte
Luis Vicente
LV
Intensive and Critical Medicine, Neurosurgical Intensive Care Unit, Hospital Meridional, Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo, SP, Brazil. fortelv@uol.com.br
Peluso
Cássio Morano
CM
Prandini
Mirto Nelso
MN
Godoy
Roberto
R
Rojas
Salomon Soriano Ordinola
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056424:Decompressive Craniectomy; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods*; D019586:Intracranial Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult