Hypotermie u TBI – up to date 2011 - Česká společnost ...

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Clifton Lancet Neurology 2010 The NABIS: H II trial therefore tested the effects of very early hypothermia in adults with severe nonpenetrating brain injury. Enrollment occurred from December 2005 to June 2009, when the trial was terminated for futility. There was concern over slow accrual and patient safety, the investigators say. The primary analysis centers on 97 patients — 52 in the hypothermia group and 45 in the normothermia group — who were followed up from June 2006 to December 2009. For patients in the hypothermia group, the mean time to reach 35°C was 2.6 hours and to reach 33°C was 4.4 hours. Hypothermia was maintained for a fixed duration of 48 hours. According to the investigators, poor outcomes (severe disability, vegetative state, or death) were equally common and not significantly different in the hypothermia group and the normothermia group. Table 1. Poor Outcome by Treatment Primary Analysis Hypothermia, No. (%) (n = 52) Normothermia, No. (%) (n = 45) RR (95% CI) P Value Poor outcome31 (60)25 (56)1.08 (0.76 – 1.53).67CI = confidence interval; RR = relative risk
Subgroup Analysis 'Interesting' However, results of a subgroup analysis suggested a significant benefit of hypothermia in patients with surgically evacuated hematomas but not in patients with diffuse brain injury.
Page 1 and 2: Hypotermie u Traumatic Brain Injury
Page 3 and 4: Význam kraniocerebrálních poran
Page 5 and 6: Základní neuroprotektivní opatř
Page 7 and 8: Patofyziologie
Page 9 and 10: Následky ischémie(zjednodušeně)
Page 11 and 12: Farmakologická neuroprotekce Ca bl
Page 13 and 14: Neuroprotektivní účinky hypoterm
Page 15 and 16: Neuroprotektivní účinky hypoterm
Page 17 and 18: Působení hypotermie
Page 19 and 20: V experimentu je neuroprotektivní
Page 21 and 22: Důvody neuroprotektivní úspěšn
Page 24 and 25: Léčebná hypotermie Součást dop
Page 26 and 27: Hypothermia Treatment for Traumatic
Page 28 and 29: Hypothermia does not increase the r
Page 30 and 31: Závěry - hypotermie snižuje ICP
Page 32 and 33: Akutní diseminovaná encephalomyel
Page 34 and 35: Výsledky u pac. s primárním pora
Page 36 and 37: Mírná hypotermie 34°C 72 hodin -
Page 40 and 41: Subgroup Analysis Poor Outcome No.
Page 42 and 43: Hypothermia in patients with brain
Page 44: Zahřívání do normotermie ! opti
Page 47 and 48: Měření teploty Doporučení: mon
Page 51 and 52: Měření teploty Mozek-lokalizace
Page 53 and 54: Metody chlazení Povrchové - celot
Page 55 and 56: Endovaskulární chlazení
Page 57 and 58: RhinoChill selektivní chlazení mo
Page 59: Helma zmrazí motorkářovu hlavu a

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