[Effects of induced hypothermia in critically ill children].
Paraules clau
Resum
OBJECTIVE
To study the efficacy of induced hypothermia (IH) in children, its effect on hemodynamic, hematological, and biochemical parameters and its side effects.
METHODS
Retrospective, observational study.
METHODS
Pediatric intensive care unit.
METHODS
Pediatric patients requiring induced hypothermia.
METHODS
None.
METHODS
The following variables were recorded prior to the initiation of IH and after 4, 24, 48, 72, and 120 hours: heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), diuresis, dose of inotropic, sedative, and muscle relaxant drugs, fluid balance, hematocrit, white cell count, white cell differential percentages, platelet count, blood levels of glucose, sodium, and potassium, C reactive protein, lactate, coagulation times, pressure ulcers, shivering, infections and death.
RESULTS
Thirty-one patients with a mean age of 20 months (SD: 39.8) were included in the study. The mean duration of IH was 3.97 days (range: 1 to 11 days). Among the IH effects, there was a significant fall in heart rate, with no changes in SBP, DBP, or diuresis. The blood tests revealed a progressive and significant fall in platelet count and an increase in C reactive protein levels. The fall in hematocrit and glucose and lactate levels was not significant. Positive cultures were detected in 25.8% of the patients during IH, most commonly from the bronchial aspirate (65%).
CONCLUSIONS
Induced hypothermia can be useful in some critically ill children. Tolerance is generally good and there are usually few side effects, which can be controlled through appropriate monitoring.
