• Shinya Murata, Mitsuru Kashiwagi, Takuya Tanabe, Chizu Oba, Seiji Shigehara, Satoshi Yamazaki, Atsuko Ashida, Akihiko Sirasu, Keisuke Inoue, Keisuke Okasora, and Hiroshi Tamai.
• Department of Pediatrics, Hirakata City Hospital, Japan.
• Brain Dev. 2016 Mar 1; 38 (3): 317-23.

BackgroundThe goals of this study, conducted in our secondary emergency care hospital, were to assess the effectiveness of targeted temperature management (TTM) for acute encephalopathy secondary to status epilepticus and to consider appropriate adaptations for use of TTM in this setting.MethodsMedical records of patients admitted with acute encephalopathy to Hirakata City Hospital between January 2010 and December 2014 were retrospectively reviewed. Cases treated with TTM (36 °C) and methylprednisolone pulse (MP) therapy (TTM/MP) were compared with those treated with conventional MP regarding clinical courses and outcomes.ResultsIn total, 20 children were retrospectively enrolled. In the TTM/MP group (10 cases) all survived intact. In the MP group (10 cases), 4 cases were left with neurological sequelae. Furthermore, in the TTM/MP group, the body temperature dropped more quickly. For pediatricians in this secondary emergency hospital, implementing the body temperature management system was not difficult. There were no complications caused by hypothermia.DiscussionUse of TTM as the initial treatment for acute encephalopathy in the early-onset stage is possible in a secondary emergency care hospital. However, some acute encephalopathy cases are the so-called fulminant type; DIC or shock develops soon after onset and so it is sometimes difficult to introduce TTM. Fulminant-type patients should be transported to tertiary emergency care hospitals. Secondary emergency care hospitals must carefully select cases for TTM, keeping the possibility of transport to a tertiary emergency hospital in mind at all times.Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

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