Acute and Critical Care

Review Article

Neurosurgery
Target temperature management in traumatic brain injury with a focus on adverse events, recognition, and prevention: Kwang Wook Jo; Acute Crit Care. 2022;37(4):483-490. Published online November 10, 2022; DOI: https://doi.org/10.4266/acc.2022.01291

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Traumatic brain injury (TBI) is a critical cause of disability and death worldwide. Many studies have been conducted aimed at achieving favorable neurologic outcomes by reducing secondary brain injury in TBI patients. However, ground-breaking outcomes are still insufficient so far. Because mild-to-moderate hypothermia (32°C–35°C) has been confirmed to help neurological recovery for recovered patients after circulatory arrest, it has been recognized as a major neuroprotective treatment plan for TBI patients. Thereafter, many clinical studies about the effect of therapeutic hypothermia (TH) on severe TBI have been conducted. However, efficacy and safety have not been demonstrated in many large-scale randomized controlled studies. Rather, some studies have demonstrated an increase in mortality rate due to complications such as pneumonia, so it is not highly recommended for severe TBI patients. Recently, some studies have shown results suggesting TH may help reperfusion/ischemic injury prevention after surgery in the case of mass lesions, such as acute subdural hematoma, and it has also been shown to be effective in intracranial pressure control. In conclusion, TH is still at the center of neuroprotective therapeutic studies regarding TBI. If proper measures can be taken to mitigate the many adverse events that may occur during the course of treatment, more positive efficacy can be confirmed. In this review, we look into adverse events that may occur during the process of the induction, maintenance, and rewarming of targeted temperature management and consider ways to prevent and address them.

Citations

Citations to this article as recorded by

Trends and hotspots in research of traumatic brain injury from 2000 to 2022: A bibliometric study
Yan-rui Long, Kai Zhao, Fu-chi Zhang, Yu Li, Jun-wen Wang, Hong-quan Niu, Jin Lei
Neurochemistry International.2024; 172: 105646. CrossRef
Severe traumatic brain injury in adults: a review of critical care management
Siobhan McLernon
British Journal of Neuroscience Nursing.2023; 19(6): 206. CrossRef

Case Report

Diffusion-weighted Imaging of a Patient in a Hypoglycemic Coma: A Case Report: Kwang Wook Jo, Hoon Kim; Korean J Crit Care Med. 2010;25(1):30-32.; DOI: https://doi.org/10.4266/kjccm.2010.25.1.30

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Abstract PDF

A 65-year-old woman with type 2 diabetes mellitus was found in an unresponsive state and she was admitted to our hospital. She was comatose on arrival. The bedside blood glucose level on admission was 15 mg/dl (normal range, 55-110 mg/dl). After emergency infusion with 50% dextrose, the blood glucose level rapidly normalized to 98 mg/dl, but there was no clinical improvement of her consciousness. Three days after admission, diffusion-weighted magnetic resonance imaging of the brain revealed bilateral temporal, occipital and frontal lobes lesions with high signal intensity. The patient's neurological condition did not change over the next 15 days. She died of pneumonia on the 30th day of hospitalization. DWI may be useful for detecting and making the differential diagnosis of hypoglycemic coma. Further, marked differences in the neuroimaging patterns of patients in a hypoglycemic coma are valuable prognostic predictors. We report here on a case of hypoglycemic coma with a poor outcome.

Citations

Citations to this article as recorded by

Consideration of Prognostic Factors in Hypoglycemic Encephalopathy
Ik-Kwon Seo, Woo-Ik Choi, Sang-Chan Jin, Hyuk-Won Chang
Korean Journal of Critical Care Medicine.2012; 27(4): 209. CrossRef

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