Influence of Artificial Therapeutic Hypothermia on Treatment Outcomes in Patients with Complicated Intracranial Aneurysmal Hemorrhages

S.O. Dudukina, Yu.Yu. Kobeliatskyi

Abstract


Objective: to define the influence of artificial therapeutic hypothermia on outcomes of surgical treatment and to evaluate survival rate in patients with complicated intracranial aneurysmal hemorrhages.
Materials and Methods. 328 patients with intracranial aneurysmal hemorrhages were included in the research. Depending on the treatment regimen for secondary brain ischemia, patients were divided into two groups. First group included 75 patients, who were treated traditionally. Therapeutic hypothermia for 48 hours as an alternative treatment mode in secondary brain ischemia with intracranial hypertension treatment was used in 29 patients who represented the second study group. Treatment outcomes were compared in groups immediately after surgery, in 6 months and 2.5 years. Survival function was assessed within 86 months.
Results. In 31.7 % of patients, the course of aneurysmal hemorrhage in the postoperative period was complicated by secondary brain ischemia with intracranial hypertension development. Usage of therapeutic hypothermia in patients with complicated intracranial aneurysmal hemorrhages helps to restore neurological functions and reduces mortality. Application of therapeutic hypothermia improves survival rate of patients with intracranial aneurysmal hemorrhages complicated by secondary brain ischemia in the postoperative period.


Keywords


therapeutic hypothermia; intracranial aneurysmal hemorrhages

References


Nasledov a. spss 19: professionalnyj statisticheskij analiz dannyx. - 2011.– Spb.: Piter. – 400 s.

Glanc s. mediko-biologicheskaya statistika. - 2008. – M.: Ppraktika. – 459 s.

Farag E, Ebrahim Z, Traul D, Katzan I, Manno E. Perioperative management of intracranial aneurysm and subarachnoid hemorrhage. Curr Pharm Des. 2013;19(32):5792-808. doi: 10.2174/13816128113199990062

Gal R. Smrcka M: Mild hypothermia for intracranial aneurysm surgery // Bratislava Medical Journal 2008, 109(2), 66-70.

Jennett B., Bond M: Assessment of outcome after severe brain damage. Lancet 1975,1 (7905), 480–484

Karnatovskaia LV, Wartenberg KE, Freeman WD : Therapeutic hypothermia for neuroprotection: history, mechanisms, risks, and clinical applications. The Neurohospitalist 2014, 4(3), 153-163. doi: 10.1177/1941874413519802.

Lazaridis C, Naval N. Risk factors and medical management of vasospasm after subarachnoid hemorrhage. Neurosurg Clin N Am. 2010 Apr;21(2):353-64. doi: 10.1016/j.nec.2009.10.006

Lee Y, Zuckerman SL, Mocco J. Current controversies in the prediction, diagnosis, and management of cerebral vasospasm: where do we stand? Neurol Res Int. 2013;2013:373458. doi: 10.1155/2013/373458.

Martin Seule and Emanuela Keller Hypothermia after aneurysmal subarachnoid hemorrhage Crit Care. 2012; 16(Suppl 2): A16. doi:10.1186/cc11274

Steiner T. European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage/ T. Steiner, S. Juvela, A.Unterberg, C.Jung // Cerebrovasc Dis. - 2013. - №35 (2).-P.93-112. doi: 10.1159/000346087

Zacharia BE, Hickman ZL, Grobelny BT, DeRosa P, Kotchetkov I, Ducruet AF, Connolly ES Jr. Epidemiology of aneurysmal subarachnoid hemorrhage. Neurosurg Clin N Am. 2010 Apr;21(2):221-33. doi: 10.1016/j.nec.2009.10.002.




DOI: https://doi.org/10.22141/2224-0586.1.64.2015.79622

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта