How I Cool Children in Neurocritical Care
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- Fink, E.L., Kochanek, P.M., Clark, R.S.B. et al. Neurocrit Care (2010) 12: 414. doi:10.1007/s12028-010-9334-5
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Brain injury is the leading cause of death in our pediatric ICU [Au et al. Crit Care Med 36:A128, 2008]. Clinical care for brain injury remains largely supportive. Therapeutic hypothermia has been shown to be effective in improving neurological outcome after adult ventricular-arrhythmia-induced cardiac arrest and neonatal asphyxia, and is under investigation as a neuroprotectant after cardiac arrest and traumatic brain injury in children in our ICU and other centers. To induce hypothermia in children comatose after cardiac arrest we target 32–34°C using cooling blankets and intravenous iced saline as primary methods for induction, for 24–72 h duration with vigilant re-warming. The objective of this article is to share our hypothermia protocol for cooling children with acute brain injury.