J.Jpn. Surg. Soc.. 100(7): 443-448, 1999

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THE BRAIN HYPOTHERMIA THERAPY FOR PREVENTION OF VEGETATION AFTER SEVERE BRAIN INJURY

We have presented a new concept of brain hypoxia oriented brain hypothermia treatments. All severe brain injury patients (148 cases) were GCS < 6. The masking brain hypoxia by brain thermo pooling, catecholamine surge induced cardiac dysfunction and intestinal vasodilatation, reduction of Hb-2, 3 diphosphoglyserate were major target of initial treatment. These specific brain hypoxia was only controlled by brain hypothermia (34～32℃), oxygen delivery >800ml/min. and AT-III >100％. 2. The brain hypothermia were very successful to prevent masking brain hypoxia, selective radical attack to A10 dopamine nervous system, and brain edema. However, metabolic shift to lipid metabolism and lower growth hormone related immune crisis were recorded as a negative factors. Clinical results were so advanced. The mortality were 44 in 148 cases (30％), good recovery were 59 in 148 cases (40％), mild disability were 20 in 148 cases (13％) and vegetate state were only 15 in 148 cases (10％). The combination of brain hypothermia and replacement of cerebral dopamine were very successful to prevent the vegetation in severe brain injury.

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