Abstract
The effects of hypothermia on coagulation may represent a two-edged sword in patients with acute brain injury who are treated with therapeutic cooling. On the one hand inhibition of coagulation can have positive effects, such as improvements in the microcirculation and inhibition of the formation of harmful microthrombi in the brain [1]. On the other hand this could lead to increased bleeding risk and thereby cause harm to patients, especially if they have suffered traumatic injuries or are actively bleeding for other reasons. This manuscript will briefly discuss what is known about the effects of hypothermia on cooling.
Highlights
A1 Update on therapeutic temperature management Gregor Broessner1*, Marlene Fischer1, Gerrit Schubert2, Bernhard Metzler3, Erich Schmutzhard1 1Department of Neurology, Medical University, Innsbruck, Austria; 2Department of Neurosurgery, Medical University, Innsbruck, Austria; 3Department of Cardiology, Medical University, Innsbruck, Austria Critical Care 2012, 16(Suppl 2):A1It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium
Mild therapeutic hypothermia after cardiac arrest has become standard in post-resuscitation care in many hospitals as it is recommended by current guidelines
Some authors report that both b1-adrenoceptors and aadrenoceptors increase their sensitivity to catecholamines during hypothermia [18,20,21,22] as b1-adrenoceptor activity was potentiated by low temperature, and they claim the existence of hypothermia-induced supersensitivity and increased agonist activity for b1-adrenoceptors
Summary
A1 Update on therapeutic temperature management Gregor Broessner1*, Marlene Fischer, Gerrit Schubert, Bernhard Metzler, Erich Schmutzhard1 1Department of Neurology, Medical University, Innsbruck, Austria; 2Department of Neurosurgery, Medical University, Innsbruck, Austria; 3Department of Cardiology, Medical University, Innsbruck, Austria Critical Care 2012, 16(Suppl 2):A1It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. It could be shown that hypothermia may lead to increased rate of infections, hypotension, shivering, disturbances in blood clotting, rewarming injuries and significant changes in pharmacokinetics and pharmacodynamics possibly limiting outcome effects of the treated patients [4,5,6,7,8]. Aggressive treatment of fever in the ICU without risk elevation through the side effects of therapeutic hypothermia led to the concept of controlled prophylactic normothermia This concept is based upon strict control of body core temperature with a target of 36.5°C beginning as early as possible with the goal of complete fever prevention. All planned measures to reduce reperfusion damage before revascularization should preferably be applied in a very short time
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