Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury

Early-Onset Ventilator-Associated Pneumonia in Patients with Severe Traumatic Brain Injury: Incidence, Risk Factors, and Consequences in Cerebral Oxygenation and Outcome

“…This association was previously demonstrated in patients that received therapeutic hypothermia after successful resuscitation from a cardiac arrest [35,36]. Perbet et al [35] showed that approximately 65% of this population developed EOVAP.…”

“…More recently, O'Phelan et al conducted a retrospective study involving 114 patients with severe TBIs. They demonstrated that therapeutic temperature modulation was significantly associated with pneumonia [36]. We found other factors associated with EOVAP, including gastric aspiration, positive culture of an endotracheal aspiration sample acquired at admission, and associated thoracic injury (AIS score C3).…”

Direct Brain Cooling in Treating Severe Traumatic Head Injury

“…There are previously multiple papers that suggested targeted brain cooling as a reasonable treatment option to patient with severe traumatic brain injury [21][22][23][24][25][26][27][28][29][30][31][32][33]. Targeted brain cooling is a good alternative to systemic hypothermia, as systemic hypothermia has serious side effects such as circulatory constrain, increased risk of infection, electrolyte imbalance, and coagulopathy [15][16][17][18].…”

“…However, the pitfall of the treatment is that it is associated with alteration of the body core temperature and hence induced alteration in the systemic function and affecting the whole body hemostasis. Few possible adverse systemic complications that are associated with induced systemic hypothermia treatment include increase risk of infection and sepsis, pneumonia, poor wound healing and breakdown, cardiac arrhythmias, coagulopathy and electrolytes imbalances such as hypoglycemia and hypokalemia [12][13][14][15][16][17][18]. These systemic complications may outweigh the beneficial effect of the hypothermia treatment.…”

Topical respiratory strategies in neurocritical care

“…С учетом того, что индуцированная гипо-, нормотермия обладает нейропротективными эффектами и является одной из наиболее эффективных опций коррекции внутричерепной гипертензии, управление температурой тела следует расценивать в качестве одной из наиболее эффективных аддитивных респираторных стратегий в нейрореанимации. Однако следует помнить, что управление температурой тела, особенно терапевтическая гипотермия, является агрессивной методикой интенсивной терапии, поэтому принимать решение о ее использовании следует взвешенно и обдуманно [85,86]. Вместе с тем лихорадка у нейрореанимационного пациента в остром периоде заболевания, осложнившегося развитием РДС с гиперекапнией, должна быть купирована как можно быстрее.…”