Medicina intensiva · 2010
[Effects of induced hypothermia in critically ill children].
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Mencía S, Berroya A, López-Herce J, Botrán M, Urbano J, Carrillo A
Аннотация
OBJECTIVE: To study the efficacy of induced hypothermia (IH) in children, its effect on hemodynamic, hematological, and biochemical parameters and its side effects.
DESIGN: Retrospective, observational study.
SETTING: Pediatric intensive care unit.
PATIENTS: Pediatric patients requiring induced hypothermia.
INTERVENTIONS: None.
DATA COLLECTED: The following variables were recorded prior to the initiation of IH and after 4, 24, 48, 72, and 120 hours: heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), diuresis, dose of inotropic, sedative, and muscle relaxant drugs, fluid balance, hematocrit, white cell count, white cell differential percentages, platelet count, blood levels of glucose, sodium, and potassium, C reactive protein, lactate, coagulation times, pressure ulcers, shivering, infections and death.
RESULTS: Thirty-one patients with a mean age of 20 months (SD: 39.8) were included in the study. The mean duration of IH was 3.97 days (range: 1 to 11 days). Among the IH effects, there was a significant fall in heart rate, with no changes in SBP, DBP, or diuresis. The blood tests revealed a progressive and significant fall in platelet count and an increase in C reactive protein levels. The fall in hematocrit and glucose and lactate levels was not significant. Positive cultures were detected in 25.8% of the patients during IH, most commonly from the bronchial aspirate (65%).
CONCLUSIONS: Induced hypothermia can be useful in some critically ill children. Tolerance is generally good and there are usually few side effects, which can be controlled through appropriate monitoring.
DESIGN: Retrospective, observational study.
SETTING: Pediatric intensive care unit.
PATIENTS: Pediatric patients requiring induced hypothermia.
INTERVENTIONS: None.
DATA COLLECTED: The following variables were recorded prior to the initiation of IH and after 4, 24, 48, 72, and 120 hours: heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), diuresis, dose of inotropic, sedative, and muscle relaxant drugs, fluid balance, hematocrit, white cell count, white cell differential percentages, platelet count, blood levels of glucose, sodium, and potassium, C reactive protein, lactate, coagulation times, pressure ulcers, shivering, infections and death.
RESULTS: Thirty-one patients with a mean age of 20 months (SD: 39.8) were included in the study. The mean duration of IH was 3.97 days (range: 1 to 11 days). Among the IH effects, there was a significant fall in heart rate, with no changes in SBP, DBP, or diuresis. The blood tests revealed a progressive and significant fall in platelet count and an increase in C reactive protein levels. The fall in hematocrit and glucose and lactate levels was not significant. Positive cultures were detected in 25.8% of the patients during IH, most commonly from the bronchial aspirate (65%).
CONCLUSIONS: Induced hypothermia can be useful in some critically ill children. Tolerance is generally good and there are usually few side effects, which can be controlled through appropriate monitoring.