Effects of Dexamethasone on Pulmonary Oxygenation Impairments in Therapeutic Hypothermia for Patients with Traumatic Brain InjuryMayuki Aibiki*, Kensuke Umakoshi, Saori Ohtsubo, Satoshi Kikuchi, Hironori Matsumoto, Muneaki Ohshita, Soichi Maekawa and Takashi Nishiyama
Department of Emergency Medicine, School of Medicine, Ehime University, Japan
- Corresponding Author:
- Dr. M. Aibiki
Department of Emergency Medicine
Ehime University, Shitsukawa 454, Tohon
791-0295, Ehime, Japan
E-mail: [email protected]
Received date: June 10, 2013; Accepted date: September 11, 2013; Published date: September 16, 2013
Citation: Aibiki M, Umakoshi K, Ohtsubo S, Kikuchi S, Matsumoto H, et al. (2013) Effects of Dexamethasone on Pulmonary Oxygenation Impairments in Therapeutic Hypothermia for Patients with Traumatic Brain Injury. J Neurol Neurophysiol 4:164. doi:10.4172/2155-9562.1000164
Copyright: © 2013 Aibiki M et al.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: We studied retrospectively to examine differences in the occurrence rate of pneumonia and the
time-course changes in pulmonary oxygenation between hypothermic and normothermic therapies with or without
dexamethasone (D) administration in patients with traumatic brain injury (TBI).
Design: A retrospective observational study.
Setting: Two university hospitals.
Subjects and Methods: In consecutive TBI patients (GCS ≤ 8) treated with hypothermic (N=23, 32-33°C) or
normothermic (N=16, 36-37.5°C) therapy, the occurrence rate of pneumonia, PaO2/FIO2 (P/F) ratios and C-reactive
protein (CRP) levels were examined. The comparisons were made among hypothermic and normothermic groups
with or without D administration. In several patients in both groups, neutrophil functions were examined. Data were
analyzed with ANOVA followed by Sheffe’s F-test, Mann-Whitney U-test, Kruskal-Wallis tests or chi-squared test
(p<0.05) as appropriate.
Results: The occurrence rate of pneumonia in a hypothermic group with D administration was significantly
lower than in a hypothermic group without D. In the hypothermic group without D treatment, CRP elevation during
the rewarming phase occurred, which was followed by more severe P/F ratio deteriorations as compared to the
hypothermic group given D. Neutrophil phagocytic functions in hypothermic patients without D were activated
around 35°C, which were followed by marked decreases in pulmonary oxygen. In contrast, phagocytic function in a
hypothermic patient receiving D was depressed, but without P/F ratios below 280.
Conclusion: This study poses hypotheses that neutrophils play a role in the pulmonary oxygenation impairment in
hypothermic therapy for TBI patients, and that dexamethasone improves the pulmonary complications in therapeutic