Therapeutic hypothermia complicated by spontaneous brain stem hemorrhage

Hypothermia increases clotting time, which is known as hypothermic coagulopathy. However, prothrombin time and activated partial thromboplastin time prolongation associated with therapeutic hypothermia is usually mild and thus, hypothermic coagulopathy is not considered to cause clinically significa...

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Bibliographic Details
Published in:The American journal of emergency medicine 2013, Vol.31 (1), p.266.e1-266.e3
Main Authors: Cho, Hang Joo, MD, Kyong, Yeon Young, MD, Oh, Young Min, MD, Choi, Se Min, PhD, Choi, Kyoung Ho, PhD, Oh, Joo Suk, MD
Format: Article
Language:English
Subjects:
Blood platelets
Brain Stem - blood supply
Cardiac arrest
Cardiopulmonary Resuscitation
Creatinine
Diagnosis, Differential
Emergency
Emergency medical care
Enzyme kinetics
Fatal Outcome
Hemorrhage
Humans
Hypothermia
Hypothermia, Induced - adverse effects
Intracranial Hemorrhages - diagnosis
Intracranial Hemorrhages - etiology
Kinases
Magnetic Resonance Imaging
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - diagnosis
Out-of-Hospital Cardiac Arrest - therapy
Temperature
Tomography, X-Ray Computed
Trauma
Traumatic brain injury
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Summary:Hypothermia increases clotting time, which is known as hypothermic coagulopathy. However, prothrombin time and activated partial thromboplastin time prolongation associated with therapeutic hypothermia is usually mild and thus, hypothermic coagulopathy is not considered to cause clinically significant bleeding. On the other hand, PT and aPTT do not seem to reflect the severity of hypothermic coagulopathy. Serious bleeding complications of therapeutic hypothermia has not been reported previously. Herein, we introduce a case of spontaneous brain stem hemorrhage as a complication of therapeutic hypothermia-induced coagulopathy.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2012.04.017