Vere pneumonia Sepsis Arrhythmia OthersP 0.AIS, Abbreviated Injury Score; DIC, disseminated intravascular coagulation; MTH, mild therapeutic hypothermia.THERAPEUTIC TEMPERATURE MANAGEMENT REGIMENS IN AIS 3?FIG. 1. Alterations of platelet counts between MTH (32 ?4 ) and fever control group (35 5 ?7 ) in AIS 3? and 5. (A) Comparisons of platelet counts between MTH and fever control group in AIS 3?. (B) Comparisons of platelet counts between MTH and fever control group in AIS 5. Patients who received MTH at 32 ?4 are indicated in gray, and those who received fever control at 35 5 ?7 are indicated in white. The boxes are the 25th to 75th percentile and the whiskers are the 5th to 95th percentiles. p < 0.05 compared with data between MTH group and fever control group. AIS, Abbreviated Injury Scale; MTH, mild therapeutic hypothermia.control group both on day 1 and day 3 in the patients with AIS 5 ( p = 0.03 on day 1, p < 0.01 on day 3). Causes of death Degeneration in intracerebral FGF-401 chemical information 20799856″ title=View Abstract(s)”>PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20799856 lesion was the leading cause of death in both groups (Table 6). In the MTH group, sepsis and arrhythmia were observed in one patient each in AIS 3? patients. In AIS 5 patients, degeneration in intracerebral lesion was the dominant cause of death. Period from admission to death In AIS 3? patients who died from degeneration in intracerebral lesion, the period from admission to death was significantly shorter in the MTH group than in the fever control group (medians [IQR]: 10 [6?3] vs. 17 [13?5], p < 0.05). Discussion In the present post hoc study, fever control management was significantly associated with reduction of mortality (9.7 vs. 34 ) Table 6. Causes of Death and the Number in Both Groups MTH Fever control (32 ?4 ) (35.5 ?7 ) 11 1 1 3 9 1 1 1 3 0 0 0 0.56 7 0 0Variable AIS head 3? Degeneration in intracerebral lesion Sepsis Arrhythmia Others AIS head 5 Degeneration in intracerebral lesion DIC Pneumonia Ruptured aortic aneurysmP 0.AIS, Abbreviated Injury Score; DIC, disseminated intravascular coagulation; MTH, mild therapeutic hypothermia.compared with MTH in patients with AIS head 3?. In both groups, we actively controlled core body temperature at 35.5 ?7 or 32 ?4 for more than 72 h and prevented hyperpyrexia (<38 ) for 4 days after rewarming. Consequently, these strict temperature managements were performed for at least 7 days. Additionally, hemodynamics such as CI and CPP were always higher in the fever control group than those in the MTH group on day 1 and 3. These two major results might be associated with a high rate of favorable outcome. A recent RCT showed no difference in neurological outcomes between the MTH group and the fever control group in patients with cardiac arrest.18 A Cochrane review was unable to find any RCTs that evaluated the benefit of modest cooling (35 ?7 ) for TBI.19 At this juncture, it is unclear whether achieving hypothermia or merely preventing hyperthermia is more effective in patients with severe, acute brain insults. Using historical controls, Tokutomi and colleagues compared targeted temperature management at 35 with 33 in patients with severe TBI and observed no statistically significant difference in neurological outcome or mortality.20 They compared targeted temperature management at 35 with 33 in patients with severe TBI, and demonstrated relatively lower mortality in the 35 hypothermia group (27 vs. 48 , p = 0.08). In their study, C-reactive protein levels remained significantly higher after rewarming in t.
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