How I cool children in neurocritical care

Neurocrit Care. 2010 Jun;12(3):414-20. doi: 10.1007/s12028-010-9334-5.


Brain injury is the leading cause of death in our pediatric ICU [Au et al. Crit Care Med 36:A128, 2008]. Clinical care for brain injury remains largely supportive. Therapeutic hypothermia has been shown to be effective in improving neurological outcome after adult ventricular-arrhythmia-induced cardiac arrest and neonatal asphyxia, and is under investigation as a neuroprotectant after cardiac arrest and traumatic brain injury in children in our ICU and other centers. To induce hypothermia in children comatose after cardiac arrest we target 32-34 degrees C using cooling blankets and intravenous iced saline as primary methods for induction, for 24-72 h duration with vigilant re-warming. The objective of this article is to share our hypothermia protocol for cooling children with acute brain injury.

Publication types

  • Review

MeSH terms

  • Adult
  • Asphyxia Neonatorum / complications*
  • Asphyxia Neonatorum / therapy*
  • Body Temperature
  • Brain Damage, Chronic / prevention & control*
  • Brain Injuries / therapy*
  • Child
  • Coma / therapy*
  • Critical Care / methods*
  • Glasgow Coma Scale
  • Heart Arrest / complications*
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced / methods*
  • Infant, Newborn
  • Intensive Care Units, Pediatric
  • Randomized Controlled Trials as Topic
  • Rewarming / methods