Hypothermia, immune suppression and SDD: can we have our cake and eat it?
Department of Critical Care Medicine, University of Pittsburgh Medical Center, 3550 Terrace Street, 601A Scaife Hall, Pittsburgh, PA 15261, USA
Critical Care 2011, 15:144 doi:10.1186/cc10080
Please see related research by Kamps et al., http://ccforum.com/content/15/1/R48Published: 31 March 2011
In vitro studies and clinical observations suggest that both accidental and controlled/therapeutic hypothermia have a strong immunosuppressive effect, and that hypothermia increases the risk of infections, especially wound infections and pneumonia. In the previous issue of Critical Care, Kamps and colleagues report that when hypothermia was used for prolonged periods in patients with severe traumatic brain injury in conjunction with selective decontamination of the digestive tract, the risks of infection were the same or lower in patients treated with therapeutic cooling. The risk of infection is widely regarded as the most important danger of therapeutic cooling. The findings of Kamps and colleagues need to be verified in prospective trials and in higher-resistance environments, but raise the possibility of cooling for prolonged periods with greatly reduced risk. We may be able to have our cake and eat it.