Targeted Temperature Management in Critical care Neurology
Keywords:
Targeted temperature management, Neuroprotective therapy, hypoxic-ischemic cascade, Intracranial pressure, Surface cooling, Endovascular coolingAbstract
Two major objectives of targeted temperature management (TTM) in critical care neurology are to provide neuroprotective treatment and to control intracranial pressure (ICP). TTM is the most promising neuroprotective therapy due to its multiple sites of action against hypoxic-ischemic cascade. TTM is useful for ICP reduction. Hypoxic-ischemic brain damage and elevated ICP are common catastrophic conditions in critical care neurology. Two most reliable methods using in clinical practice and clinical trials are invasive endovascular technique and non-invasive surface cooling. Rapid induction, smooth sustainment and gradual rewarming are the important steps to achieve perfect TTM. Shivering is the most important physiologic response found during the process of TTM. Several randomized control trials have indicated that TTM gives favorable outcomes in patients with post-cardiac arrest syndrome (PCAS). Although TTM shows very promising results in pre-clinical studies, its clinical use in patients with ischemic stroke and traumatic brain injury is still controversial. TTM can apply to various clinical conditions associated with hypoxic-ischemic brain injury and elevated ICP in critical care neurology.
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2019-02-13
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Konmun S, Sriratanaporn S, Kitti-udom S, Muengtaweepongsa S. Targeted Temperature Management in Critical care Neurology. J Thai Stroke Soc [Internet]. 2019 Feb. 13 [cited 2024 Dec. 26];16(3):27-48. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172101
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
