title: The study of systemic general circulation disturbance during the initiation of therapeutic hypothermia: Pit fall of hypothermia.
abstract: OBJECTIVE
  Neurointensive care has reduced the mortality and improved the outcome of patients for severe brain damage, over recent decades, and made it possible to perform this therapy in safety. However, we have to understand the complications of this therapy well. The purpose of our study was to determine the systemic circulation disturbance during the initiation of therapeutic hypothermia by using this continuous neurointensive monitoring system.
  
  
  METHODS
  Ten severe brain damage patients treated with hypothermia were enrolled. All patients had Glasgow Coma Scale (GCS) less than or equal to 8, on admission.
  
  
  RESULTS
  We verified that heart rate, cardiac output, and oxygen delivery index (DO2I) decreased with decreasing core temperature. We recognized that depressed cardiac index (CI) was attributed to bradycardia, dehydration, and increased systemic vascular resistance index (SVRI) upon initiation of hypothermia.
  
  
  CONCLUSIONS
  Although the hypothermia has a therapeutic role in severe brain damage patients, we have to carry out this therapy while maintaining their cardiac output using multimodality monitoring devices during hypothermia period.
authors.affiliation: Department of Critical Care Center, Toho University Medical Center, Omori Hospital, Ota-ku, Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Honda
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Yokota
authors.forename: Ryo
authors.initials: R
authors.lastname: Ichibayashi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yoshihara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uekusa
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Seiki
authors.forename: Jun
authors.initials: J
authors.lastname: Nomoto
authors.forename: Takeki
authors.initials: T
authors.lastname: Nagao
authors.forename: Taichi
authors.initials: T
authors.lastname: Kishi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sase