Clinical application of modest hypothermia after spinal cord injury

Allan D. Levi, Barth A. Green, Michael Y. Wang, W. Dalton Dietrich, Ted Brindle, Steven Vanni, Gizelda Casella, Gina Elhammady, Jonathan Jagid

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

There is widespread interest in the use of hypothermia in the treatment of CNS injury. While there is considerable experience in the use of cooling for a variety of brain pathologies, limited data exist after spinal cord injury. In the past few years, technological advances in the induction and maintenance of cooling have been achieved and can potentially allow for a more accurate evaluation of this form of treatment. We report a series of 14 patients with an average age of 39.4 years (range, 16-62 years) with acute, complete (AIS A) cervical spinal cord injuries who underwent a protocol using an intravascular cooling catheter to achieve modest (33°C) systemic hypothermia. There was an excellent correlation between intravascular and intrathecal cerebrospinal fluid temperature. The average time between injury and induction of hypothermia was 9.17 ± 2.24 h (mean ± SEM); the time to target temperature was 2.72 ± 0.42 h; the duration of cooling at target temperature was 47.6 ± 3.1 h; the average total length of time of cooling was 93.6 ± 4 h. There was a positive correlation between temperature and heart rate. Most documented adverse events were respiratory in nature. We were able to effectively deliver systemic cooling using the cooling catheters with minimal variation in body temperature. The study represents the largest, modern series of hypothermia treatment of acute spinal cord injury with intravascular cooling techniques and provides needed baseline data for outcome studies to include larger multi-center, randomized trials.

Original languageEnglish (US)
Pages (from-to)407-415
Number of pages9
JournalJournal of neurotrauma
Volume26
Issue number3
DOIs
StatePublished - Mar 1 2009

Keywords

  • Cooling catheter
  • Hypothermia
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology

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