tailieunhanh - Báo cáo y học: "Bench-to-bedside review: Hypothermia in traumatic brain injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: Hypothermia in traumatic brain injury. | Sinclair and Andrews Critical Care 2010 14 204 http content 14 1 204 CRITICAL CARE REVIEW L_ Bench-to-bedside review Hypothermia in traumatic brain injury H Louise Sinclair and Peter JD Andrews Abstract Traumatic brain injury remains a major cause of death and severe disability throughout the world. Traumatic brain injury leads to 1 000 000 hospital admissions per annum throughout the European Union. It causes the majority of the 50 000 deaths from road traffic accidents and leaves 10 000 patients severely handicapped three quarters of these victims are young people. Therapeutic hypothermia has been shown to improve outcome after cardiac arrest and consequently the European Resuscitation Council and American Heart Association guidelines recommend the use of hypothermia in these patients. Hypothermia is also thought to improve neurological outcome after neonatal birth asphyxia. Cardiac arrest and neonatal asphyxia patient populations present to health care services rapidly and without posing a diagnostic dilemma therefore therapeutic systemic hypothermia may be implemented relatively quickly. As a result hypothermia in these two populations is similar to the laboratory models wherein systemic therapeutic hypothermia is commenced very soon after the injury and has shown so much promise. The need for resuscitation and computerised tomography imaging to confirm the diagnosis in patients with traumatic brain injury is a factor that delays intervention with temperature reduction strategies. Treatments in traumatic brain injury have traditionally focussed on restoring and maintaining adequate brain perfusion surgically evacuating large haematomas where necessary and preventing or promptly treating oedema. Brain swelling can be monitored by measuring intracranial pressure ICP and in most centres ICP is used to guide treatments and to monitor their success. There is an absence of evidence for the five commonly used treatments for raised ICP and all are .