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Targeted Temperature Management in Paediatric Traumatic Brain Injury

Don't Forget the Bubbles

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. Therapeutic hypothermia involves the stepwise process of inducing a lower core temperature, maintaining this lower temperature, and then gradually rewarming over time.

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SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

The Skeptics' Guide to EM

Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Background: We have covered therapeutic hypothermia many times on the SGEM.

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The Latest in Critical Care, 1/22/24 (Issue #26)

PulmCCM

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

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Congenital Syphilis

Pediatric EM Morsels

We have previously discussed hypothermia presentations , GBS infections , and HSV infections. If not treated early, then increased risk of poor outcomes and death. Fortunately, we have addressed many neonatal issues in the PedEMMorsels. Obviously, one of the most concerning considerations in neonates is the potential for infection.

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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. The PATCH-trauma researchers sought to address this critique. 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. 0.94) Mortality 28d 17.3%

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The Science on Targeted Temperature Management

ACEP Now

Early work on TTM in 2002 showed benefit to cooling to 33 degrees Celsius, which subsequently influenced international resuscitation guidelines to recommend mild hypothermia at 32 degrees to 34 degrees Celsius in 2005. degrees Celsius. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

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Single ventricle defects and the hunt for the best shunt

Don't Forget the Bubbles

The JET is treated by deepening sedation (to minimise exogenous and endogenous catecholamines), optimizing electrolytes and active mild hypothermia. These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? What is the best option for repair? 2017;51(1):50-57.