Therapeutic Hypothermia for Adult Viral Meningoenc

Authors: Marko Kutleša Bruno Baršić Dragan Lepur

Publish Date: 2011/01/19

Volume: 15, Issue: 1, Pages: 151-155

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Abstract

Despite the advances in critical care severe viral meningoencephalitis continues to impose high rates of morbidity and mortality Consequently new treatment strategies are needed and we present therapeutic hypothermia TH as one of the possible efficacious treatment toolsWe present the case series in an adult intensive care unit of a tertiary care hospital Eleven patients suffering from severe viral meningoencephalitis were treated with hypothermia The major indication for TH was severely impaired consciousness associated with carbon dioxide reactivity loss assessed by Transcranial Doppler Besides from the established treatment all the patients underwent TH Mild hypothermia rectal temperature of 32–34°C was maintained with continuous venovenous hemofiltrationMedian Glasgow coma scale score in our patients at admission was 8 3–10 and median Acute Physiology and Chronic Health Evaluation score was 24 12–32 The overall mortality rate was 9 1/11 Among survivors the outcome was favorable in five patients Glasgow Outcome Scale score GOS 4–5 Remaining five patients had severe residual neurological deficit GOS 3 Median GCS at discharge was 15 8–15 With respect to disease severity the outcome in presented patients was generally satisfactoryWe thank all staffs at the Department of Neuroinfections and Intensive Care Medicine of the University Hospital for Infectious Diseases “Dr Fran Mihaljević” for their enthusiasm and care We especially thank the following persons who were personally responsible for renal replacement therapy and hypothermia Marija Santini MD Vladimir Krajinović MD Dinko Raffanelli MD Tomislav Krčelić Vesna Horvat Biljana Ćoso Ivana Bačić Milan Gunčić Aranđel Mihajlović Jasenka Pauk Majdov Anica Jasenko and Renata Josipović Mraović We thank Mrs Arijana Pavelić and Mrs Marija Fijucek for their help in the preparation of the manuscript Financially supported by the grant of the Croatian minstry of science education and sports No 1081080020102

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