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Arq Neuropsiquiatr. 2009 Jun;67(2B):480-7.

Regional cooling for reducing brain temperature and intracranial pressure.

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Intensive and Critical Medicine, Neurosurgical Intensive Care Unit, Hospital Meridional, Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo, SP, Brazil.



To evaluate the effectiveness of regional cooling for reducing brain temperature (BrTe) and intracranial pressure (ICP) in patients where conventional clinical treatment has failed.


Regional cooling was carried out using ice bags covering the area of the craniectomy (regional method) in 23 patients. The BrTe and ICP were determined using a fiber optic sensor. Thirteen patients (56.52%) were female. The ages ranged from 16 to 83 years (mean of 48.9). The mean APACHE II score was 25 points (11-35). The patients were submitted, on mean, to 61.7 hours (20-96) of regional cooling.


There was a significant reduction in mean BrTe (p<0.0001--from 37.1 degrees C to 35.2 degrees C) and mean ICP (p=0.0001--from 28 mmHg to 13 mmHg).


Our results suggest that mild brain hypothermia induced by regional cooling was effective in the control of ICP in patients who had previously undergone decompressive craniectomy.

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