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Intracranial pressure monitoring during hypothermia after cardiopulmonary resuscitation

Introduction

Two randomized clinical trials explored that induced hypothermia improved outcomes in adults with coma after resuscitation from ventricular fibrillation [1, 2]. In this study, we present the usefulness of intracranial pressure (ICP) monitoring to predict the patient's outcome after induced hypothermia.

Methods

Hypothermia (34°C, 48 hours) was induced in patients after the recovery of spontaneous circulation. The indication was as follows: motor response of Glasgow coma scale ≤ 5, at least one of the brain stem reflexes intact and age 15 to 80 years. ICP and oxygen saturation of the jugular vein (SjO2) monitoring were performed during hypothermia.

Results

Hypothermia was induced in 23 patients (55%) after resuscitation. The outcome of nine patients (39%) was modified Rankin Scale 0 to 2, 11 patients (48%) were 3 to 5 and three patients (13%) were dead. ICP during hypothermia did not increase beyond 10 mmHg in neurologically good outcome patients (Figure 1). SjO2 tended to be <80% in neurologically good outcome patients (Figure 2).

Figure 1
figure1

ICP monitoring during hypothermia.

Figure 2
figure2

SjO 2 during hypothermia monitoring.

Conclusion

ICP monitoring during hypothermia was extremely useful to predict the patient's outcome. SjO2 monitoring during hypothermia was also predictable about the patient's outcome.

References

  1. 1.

    Bernard SA, et al.: N Engl J Med. 2002, 346: 557-563. 10.1056/NEJMoa003289

  2. 2.

    Dixon SR, et al.: J Am Coll Cardiol. 2002, 40: 1928-1934. 10.1016/S0735-1097(02)02567-6

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Isotani, E., Otomo, Y. & Ohno, K. Intracranial pressure monitoring during hypothermia after cardiopulmonary resuscitation. Crit Care 13, P68 (2009). https://doi.org/10.1186/cc7232

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Keywords

  • Oxygen
  • Public Health
  • Clinical Trial
  • Outcome Patient
  • Emergency Medicine