Therapeutic Hypothermia for Adult Viral Meningoencephal
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Marko Kutles،a • Bruno Bars،ic´ • Dragan Lepur
- چاپ و سال / کشور: 2011
Description
Background Despite the advances in critical care, severe viral meningoencephalitis continues to impose high rates of morbidity and mortality. Consequently, new treatment strategies are needed and we present therapeutic hypothermia (TH) as one of the possible efficacious treatment tools. Methods We present the case series in an adult intensive care unit of a tertiary care hospital. Eleven patients suffering from severe viral meningoencephalitis were treated with hypothermia. The major indication for TH was severely impaired consciousness associated with carbon dioxide reactivity loss assessed by Transcranial Doppler. Besides from the established treatment, all the patients underwent TH. Mild hypothermia (rectal temperature of 32–34C) was maintained with continuous veno-venous hemofiltration. Results Median Glasgow coma scale score in our patients at admission was 8 (3–10) and median Acute Physiology and Chronic Health Evaluation score was 24 (12–32). The overall mortality rate was 9% (1/11). Among survivors, the outcome was favorable in five patients [Glasgow Outcome Scale score (GOS) 4–5]. Remaining five patients had severe residual neurological deficit (GOS 3). Median GCS at discharge was 15 (8–15). With respect to disease severity, the outcome in presented patients was generally satisfactory. Conclusions Our results suggest that use of mild hypothermia in selected adult patients with viral meningoencephalitis could be a promising treatment tool.
Neurocrit Care (2011) 15:151–155 DOI 10.1007/s12028-010-9500-9 Published online: 19 January 2011
