Peritoneal dialysis to induce hypothermia in a head-injured patient: Case report

Cancio, Leopoldo C.; Wortham, William G.; Zimba, Frank A.

doi:10.1016/0090-3019(94)90397-2

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…(1) surface cooling (a) Blankets 2,3,6,15,16,21 (b) Ice packs or immersion in cold water 15,22 (c) Cooling helmet 7,22 (2) deep cooling (a) with cold solutions • Intravenous infusion 8,23 • Gastric washing 3,6 • Peritoneal washing 24 • Nasopharyngeal cooling 22 (b) Closed intravascular system 16 The cooling techniques were associated, in the majority of instances, with the circulation of cooled air leading to a decrease in environmental temperature to around 18ºC.…”

Section: Cooling Methodsmentioning

confidence: 99%

Regional cooling for reducing brain temperature and intracranial pressure

Forte

Peluso

Prandini

et al. 2009

Arq. Neuro-Psiquiatr.

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-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. Method: 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 37.1ºC to 35.2ºC) and mean ICP (p=0.0001-from 28 mmHg to 13 mmHg). Conclusion: 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.KEy wORds: intracranial hypertension, intracranial pressure, cerebral hypothermia, brain edema, brain injuries. Resfriamento cerebral regional para redução da temperatura e pressão intracranianaResumo -Objetivo: Avaliar a eficácia do resfriamento regional na redução da temperatura cerebral (TeCe) e pressão intracraniana (PIC) após falha das medidas clínicas convencionais de tratamento. Método: O resfriamento cerebral foi realizado com bolsas com gelo, colocadas sobre a área de craniectomia (método regional) em 23 doentes. A TeCe e PIC foram verificadas com sensor de fibra óptica. Treze (56,52%) eram do sexo feminino. A idade variou de 16 a 83 anos (média 48,96). A pontuação média no índice APACHE II foi 25 pontos . Os doentes foram submetidos, em média, a 61,7 horas (20-96) de resfriamento regional. Resultados: Houve uma redução significativa da TeCe média (p<0,0001-de 37,1ºC para 35,2ºC) e da PIC média (p=0,0001-de 28 mmHg para 13 mmHg). Conclusão: Nossos resultados sugerem que o resfriamento regional foi eficaz no controle da PIC nos doentes submetidos, previamente, a craniectomia descompressiva.PAlAvRAs-CHAvE: hipertensão intracraniana, pressão intracraniana, hipotermia induzida, edema encefálico, traumatismos encefálicos.

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Section: Cooling Methodsmentioning

confidence: 99%

Regional cooling for reducing brain temperature and intracranial pressure

Forte

Peluso

Prandini

et al. 2009

Arq. Neuro-Psiquiatr.

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“…48 Nevertheless, case series on PD have shown that changes in intracranial pressure are lesser than in HD (with CPP even improving in some cases) and without the complications of anticoagulation. [49][50][51][52] 3.1 | Risk of an increase in intra-abdominal pressure and peritoneal dialysis…”

Section: Sodium Balance Considerations In Peritoneal Dialysismentioning

confidence: 99%

“…Despite more information regarding PD in AKI, there are few reports on this group of patients and its inappropriate use could increase cerebral edema, as occurs with other AKRT methods 48 . Nevertheless, case series on PD have shown that changes in intracranial pressure are lesser than in HD (with CPP even improving in some cases) and without the complications of anticoagulation 49–52 …”

Section: Risk and Limitations Of Peritoneal Dialysis In Neurocritical...mentioning

confidence: 99%

Peritoneal dialysis and acute kidney injury in acute brain injury patients

Ramírez-Guerrero

Husain‐Syed

Ponce

et al. 2023

Seminars in Dialysis

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Acute kidney injury (AKI) is a heterogeneous syndrome with multiple etiologies. It occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. In this scenario, AKI alters the kidney–brain axis, exposing patients who receive habitual dialytic management to greater injury. Various therapies have been designed to mitigate this risk. Priority has been placed by KDIGO guidelines on the use of continuous over intermittent acute kidney replacement therapies (AKRT). On this background, continuous therapies have a pathophysiological rationale in patients with acute brain injury. A low‐efficiency therapy such as PD and CRRT could achieve optimal clearance control and potentially reduce the risk of secondary brain injury. Therefore, this work will review the evidence on peritoneal dialysis as a continuous AKRT in neurocritical patients, describing its benefits and risks so it may be considered as an option when deciding among available therapeutic options.

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“…Whether accidental or intentional, hypothermia can be induced by a variety of chemical or physical interventions, such as sustained low temperature, severe trauma, shock, anesthesia, and infusion of a large amount of fluid. 1 , 2 Reduction of body temperature suppresses a broad range of pathological and physiological processes, especially those involving energy consumption. Negative effects include lowering oxygen and glucose demands, interruption of apoptotic pathways, inhibition of pro-inflammatory cytokines, and blocking of neuroexcitatory cascades.…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo evaluation of hypothermia on pharmacokinetics and pharmacodynamics of nimodipine in rabbits

et al. 2017

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ObjectiveTo investigate the effect of hypothermia on the pharmacokinetics and pharmacodynamics of nimodipine in rabbits using in vivo and in vitro methods.MethodsFive healthy New Zealand rabbits received a single dose of nimodipine (0.5 mg/kg) intravenously under normothermic and hypothermic conditions. Doppler ultrasound was used to monitor cerebral blood flow, vascular resistance, and heart rate. In vitro evaluations of protein binding, hepatocyte uptake and intrinsic clearance of liver microsomes at different temperatures were also conducted.ResultsPlasma concentrations of nimodipine were significantly higher in hypothermia than in normothermia. Nimodipine improved cerebral blood flow under both conditions, but had a longer effective duration during the hypothermic period. Low temperature decreased the intrinsic clearance of liver microsomes, with no change in protein binding or hepatocyte uptake of nimodipine.ConclusionNimodipine is eliminated at a slower rate during hypothermia than during normothermia, mainly due to the decreased activity of cytochrome P450 enzymes. This results in elevated system exposure with little enhancement in pharmacological effect.

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Peritoneal dialysis to induce hypothermia in a head-injured patient: Case report

Cited by 9 publications

References 29 publications

Regional cooling for reducing brain temperature and intracranial pressure

Regional cooling for reducing brain temperature and intracranial pressure

Peritoneal dialysis and acute kidney injury in acute brain injury patients

In vitro and in vivo evaluation of hypothermia on pharmacokinetics and pharmacodynamics of nimodipine in rabbits

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