Therapeutic hypothermia in treatment of different cerebral injuries

A.V. Butrov1, B.D. Torosyan1, D.V. Cheboksarov1,2, G.R. Makhmutova1,2

1 Peoples Friendship University of Russia (RUDN University), Moscow

2 Moscow City clinical hospital named author V.V. Vinogradov, Moscow

For correspondence: Andrey V. Butrov, DSci, Professor, department of anaestesiology and reanimatology with clinical rehabilitation course RUDN University, Moscow; e-mail:

For citation: Butrov AV, Torosyan BD, Cheboksarov DV, Makhmutova GR. Therapeutic hypothermia in treatment of different cerebral injuries. Alexander Saltanov Intensive Care Herald. 2019;2:75-81.

DOI: 10.21320/1818-474X-2019-2-75-81


There is an increasing incidence of various cerebral eventsin Russia, as well as throughout the world. At the same time, despite of all the successes of modern medicine, the treatment outcomes of these patient groups haven’t improved. The main successes are based on faster patient delivery to hospitals and on the creation of specialized centers for this cohort of patients. At the same time, the effectiveness of pharmacological agents with neuroprotective activity is questionable. On the other hand, therapeutic hypothermia techniques have proven to be an effective method of neuroprotection in various cerebral events. These methods can be divided into local and general hypothermia. Each of these options has its own advantages and indications. Thus, the use of general hypothermia techniques maintains the target temperature of the whole body, these techniques are more controllable, but at the same time, the methods of local craniocerebral hypothermia allows to affect the target organ. The methods of hypothermia and thermostabilization have been proven to improve the treatment results of patients post-CPR and in children with neonatal hypoxia. The effectiveness of hypothermia in the remaining pathological conditions of the brain has not yet been investigated. Studies of the last 5 years have not revealed high efficacy of general hypothermia at TBI, so almost of all studies indicated that normothermia and hypothermia are equally effective. Studies are ongoing in patients with subarachnoid hemorrhage, subdural hematomas and ischemic stroke. Identifying groups of patients who are recommended for these methods for complex treatment can lead to progress in improving survival and neurological outcome.

Keywords: therapeutic hypothermia, craniocerebral hypothermia, traumatic brain injury, cerebral infarction, subarachnoid hemorrhage, cerebral hemorrhage

Received: 04.02.2019

Accepted: 26.03.2019


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Successful Completion of Pregnancy and Delivery in Patient in Coma

E.Yu. Upryamova1, A.L. Gridchik1, O.F. Serova2, M.V. Vatsik3, N.M. Smirnova3, E.M. Shifman4

1Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, Moscow

2Moscow Regional Perinatal Center, Balashikha

3Domodedovo central hospital, Domodedovo

4M.F. Vladimirskiy Moscow Regional Research Clinical Institute, Moscow

For correspondence: Upryamova Ekaterina Yur’evna — MD, Senior Researcher of the Department of Anesthesiology and Intensive Care, Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, Moscow; e-mail:

For citation: Upryamova EYu, Gridchik AL, Serova OF, Vatsik MV, Smirnova NM, Shifman EM. Successful Completion of Pregnancy and Delivery in Patient in Coma. Intensive Care Herald. 2016;4:62–66.

Severe neurological injury during pregnancy without intensive care for a woman is a potentially dangerous condition for both the mother and the fetus. High risk of secondary infection with the development of inflammatory complications, decompensation of vital functions of the mother due to the increased load on the organs and systems due to ongoing pregnancy have special requirements for the organization and carrying out of intensive care on the part of intensivist and obstetricians. In this clinical observation, we analyzed medical history, clinical and instrumental examination, especially prenatal care, intensive care and delivery of patient staying in persistent vegetative state being a result of severe traumatic brain injury.

The present clinical case is a unique event in Russian medical practice. Its uniqueness lies in the fact that the patient has spent in a coma in fact the entire pregnancy (4–5 weeks before a full-term period), that is more than 8 months. The obstetric department of Domodedovo central hospital performed cesarean section under general anesthesia when the term was around 36–37 weeks. In the 4th minute they extracted preterm alive weight 2180 g girl, 46 cm, with Apgar scores of 3–5 points. In May 2015, the specialists carried out in-depth examination of the child. According to the results of the survey, the child did not reveal any abnormalities in the development and health.

Thus, a consistent multidisciplinary approach, an individual program of intensive therapy, taking into account the type and extent of damage to the central nervous system, the parent status, gestational age and fetal condition allowed achieving significant results in the treatment and giving a chance to live for the child not yet born.

Keywords: pregnancy, delivery, traumatic brain injury, coma, persistent vegetative state, Glasgow score, Apgar score

Received: 23.09.2016


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Basic Therapy of Traumatic Brain Injury Using Catecholamine Agonist

E.АLebedeva1, E.GMarkaryan2, S.ABelyaevskij2, G.ASasian2, A.S. Sogikyan3, S.ADoroshenko2, E.VYartsev2, M.ТKlochkova2, M.LSkoblo4

1 Rostov state medical University, Rostov-on-Don

2 City hospital ambulance, Rostov-on-Don

3 Road clinical hospital at the station Rostov-Glavny, Rostov-on-Don

4 City hospital № 6, Rostov-on-Don

For correspondence: Elena А. Lebedeva — MD, associate Professor of the Department of anesthesiology and intensive care of the “Rostov state medical University”; e-mail:

For citation: Lebedeva EА, Markaryan EG, Belyaevskij SA, et al. Basic Therapy of Traumatic Brain Injury Using Catecholamine Agonist. Alexander Saltanov Intensive Care Herald. 2018;1:79–82.

DOI: 10.21320/1818-474X-2018-1-79-82

In order to determine the safety of the use of amantadine in intensive treatment of victims with severe traumatic brain injury, a prospective controlled blind randomized study was conducted, in which 31 patient were included. The first group consisted of 19 persons who underwent intensive treatment. In group II (18 people), amantadine was included in the intensive care package. The use of amantadine in the complex intensive treatment of severe traumatic brain injury at the earliest possible time (3rd day after injury), provided the correction of hemodynamics and respiration does not change the structure and does not exacerbate the manifestations of polyorgan insufficiency.

Keywords: traumatic brain injury, amantadine

Received: 31.12.2017


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