Preparation for Management of Brain Hypothermia

  • Nariyuki Hayashi
  • Dalton W. Dietrich


Stabilized systemic circulation and cardiac function is important from the beginning of treatment because serum catecholamines progressively decrease in proportion to the severity of brain tissue hypothermia [1]. Early dehydration management to prevent brain edema introduces difficult conditions for the induction of brain hypothermia treatment because of reduced systemic circulation volume and unstable cardiac output. An arrhythmia-prolonged QT-interval of more than 450 mm/s, hyperglycemia, and hypopotassemia must be controlled before the induction of hypothermia. The complication of severe pneumonia produces unsuccessful brain hypothermia because of uncontrollable increases in brain tissue glutamate associated with cytokine encephalitis. To prevent pneumonia (Mendelson’s syndrome), food and gastric juice in the stomach should be washed out by gastric lavage with 1000 ml of cooled saline, immune function should be managed by maintaining microcirculation of the intestinal organs by replacement of antithrombin III (AT-III) to above the 100% level, intestinal mucous membrane edema can be prevented by management of serum albumin levels above 3.0g/dl, and serum glucose levels should be carefully maintained between 120 and 140 mg/dl [1, 2, 3].


Osmotic Dehydration Gastric Lavage Brain Injured Patient Hypothermia Treatment Auditory Brainstem Evoke Response 


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  1. 1.
    Hayashi N (1995) Cerebral hypothermia treatment. In: Hayashi N (ed) Cerebral hypothermia treatment. Sogo Igaku, Tokyo, pp 1–105Google Scholar
  2. 2.
    Hayashi N (2000) Enhanced neuronal damage in severely brain injured patients by hypothalamus, pituitary, and adrenal axis neuro-hormonal changes. In: Hayashi N (ed) Brain hypothermia. Springer, Berlin Heidelberg New York Tokyo, pp 3–26CrossRefGoogle Scholar
  3. 3.
    Hayashi N (2000) The clinical issue and effectiveness of brain hypothermia treatment for severe brain injured patients. In: Hayashi N (ed) Brain hypothermia. Springer, Berlin Heidelberg New York Tokyo, pp 121–151CrossRefGoogle Scholar

Copyright information

© Springer Japan 2004

Authors and Affiliations

  • Nariyuki Hayashi
    • 1
    • 2
  • Dalton W. Dietrich
    • 3
    • 4
  1. 1.Nihon University Emergency Medical CenterTokyoJapan
  2. 2.Department of Emergency and Critical Care MedicineNihon University School of MedicineTokyoJapan
  3. 3.Department of Neurological Surgery, Neurology and Cell Biology and AnatomyUniversity of Miami School of MedicineMiamiUSA
  4. 4.The Miami Project to Cure ParalysisMiamiUSA

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