Characteristics of infection and leukocyte count in severely head-injured patients treated with mild hypothermia

Objective: This study was designed to characterize the infectious complicat ions and kinetics of leukocyte count in severely head-injured patients trea ted with mild hypothermia. Patients and Methods: We retrospectively analyzed the incidence and severit y of infectious complications as well as daily changes in leukocyte count i n 41 severely head-injured patients treated with mild hypothermia (group H) , They were retrospectively compared with 25 severely head-injured patients treated with high-dose barbiturates (group B) and to 25 other severely hea d-injured patients treated with no barbiturates (group N), Results: initial intracranial pressure was significantly higher in group H than in the other groups, No significant differences existed in the inciden ce of pneumonia or meningitis among the three groups, whereas the incidence of bacteremia was significantly higher in group H than in the other two gr oups, Pneumonia was significantly more severe in group H than in the other groups, In six patients of group H, pneumonia spread fulminantly to become life threatening. Daily changes in total leukocyte count showed the same pa ttern, consisting of a peak, a nadir, and a second peak in all groups. Tota l leukocyte count was, however, significantly lower during the first 2 week s in group H than in the other two groups. Lymphocyte and neutrophil counts were also lower in group H, Conclusion: Infectious. complications were more severe and leukocyte counts were lower in patients treated with mild hypothermia, who also had the hig hest initial intracranial pressures, than in patients treated with conventi onal therapies, Measures against increased susceptibility to infection and leukocyte suppression should be explored.