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Therapeutic Hypothermia and Temperature Management

Maria Mercedes Tejada de Rink, Ulrike Naumann, Rainer Kollmar, Stefan Schwab, Barbara Dietel, Hideki Harada, Miyuki Tauchi
Targeted temperature management, or therapeutic hypothermia, is a potent neuroprotective approach after ischemic brain injury. Hypothermia should be induced as soon as possible after the onset of acute stroke to assure better outcomes. Accordingly, drugs with a fast-acting hypothermic effect sustainable through the period of emergency transportation to hospital would have clinical advantages. Activation of the transient receptor potential vanilloid-1 (TRPV1) can induce hypothermia. Our immunohistochemical investigations confirmed that TRPV1 was distributed to perivascular and periventricular regions of the rat brain, where TRPV1 can be easily detected by TRPV1 agonists...
May 14, 2019: Therapeutic Hypothermia and Temperature Management
Mary Kay Bader, Patricia A Blissitt, Leslie A Hamilton, Nicole Kupchik
No abstract text is available yet for this article.
May 7, 2019: Therapeutic Hypothermia and Temperature Management
Lisa-Maria Rosenthal, Giang Tong, Sylvia Wowro, Christoph Walker, Constanze Pfitzer, Wolfgang Böttcher, Oliver Miera, Felix Berger, Katharina Rose Luise Schmitt
Therapeutic hypothermia during cardiac surgery has been widely used for neuroprotection and to attenuate the systemic inflammatory response due to cardiopulmonary bypass (CPB). Experimental data suggest that cold-shock protein RNA-binding motif 3 (RBM3), which is induced in response to hypothermia, plays a key role in hypothermia-induced organ protection. To date, investigation on RBM3 has been performed exclusively in vitro or in animal models, and the detection and regulation of RBM3 in human blood has not been investigated until now...
April 11, 2019: Therapeutic Hypothermia and Temperature Management
Lisa Mäder, Ajaz Ganai, Ilia Aroyo, Josef Schill, Regina Tröscher-Weber, Peter Huppert, Otto Kotterer, Karsten Geletneky, Rainer Kollmar
Targeted temperature management (TTM) might improve outcome of patients with severe subarachnoid hemorrhage (SAH) in which vasospasm, delayed cerebral ischemia (DCI), and increased intracranial pressure (ICP) are frequent and severe complications. A series of patients (n = 3) with severe aneurysmatic SAH were treated by TTM if they developed ICP crisis and/or severe vasospasm diagnosed by angiography. Once these complications were detected, body core temperature (BCT) was rapidly decreased to 35°C or 33°C, if necessary...
March 26, 2019: Therapeutic Hypothermia and Temperature Management
Daniel C Schroeder, Alexandra C Maul, Maria Guschlbauer, Simon-Richard Finke, David de la Puente Bethencourt, Tobias Neumann, Stephan A Padosch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
To date, the optimal cooling device for targeted temperature management (TTM) remains unclear. Water-circulating cooling blankets are broadly available and quickly applied but reveal inaccuracy during maintenance and rewarming period. Recently, esophageal heat exchangers (EHEs) have been shown to be easily inserted, revealed effective cooling rates (0.26-1.12°C/h), acceptable deviations from target core temperature (<0.5°C), and rewarming rates between 0.2 and 0.4°C/h. The aim of this study was to compare cooling rates, accuracy during maintenance, and rewarming period as well as side effects of EHEs with water-circulating cooling blankets in a porcine TTM model...
March 20, 2019: Therapeutic Hypothermia and Temperature Management
Charles Wright, Madhukar S Patel, Xiang Gao, Maxwell Witt, Mitchell Sally, Tahnee Groat, Megan Crutchfield, Nikole Neidlinger, Markeith Pilot, Darren J Malinoski
Therapeutic hypothermia (TH) is clinically used to improve neurologic outcomes in patients with anoxic brain injury after cardiopulmonary resuscitation (CPR). For patients that regress and become organ donors after neurologic determination of death (DNDDs), the impact of TH received before determination of death on organ donation outcomes remains unknown. A prospective observational study of all adult DNDDs that received CPR and had anoxia as a cause of death from March 2013 to December 2014 was conducted across 20 organ procurement organizations (OPOs) in the United States...
March 8, 2019: Therapeutic Hypothermia and Temperature Management
Bogdan Ianosi, Verena Rass, Max Gaasch, Lukas Huber, Anna Lindner, Werner O Hackl, Mario Kofler, Alois Josef Schiefecker, Salma Almashad, Ronny Beer, Bettina Pfausler, Raimund Helbok
Intravenous nonsteroidal anti-inflammatory drugs and nonopioid analgesics are used to achieve normothermia or relieve pain in patients with aneurysmal subarachnoid hemorrhage (aSAH). We investigated the effects of paracetamol (1 g), diclofenac (75 mg) and metamizole (1 g) on systemic and cerebral hemodynamics and temperature during febrile and nonfebrile episodes after aSAH. Prospectively collected data from 77 consecutive poor-grade aSAH patients with invasive neuromonitoring were included. The burden and occurrence of hypotension (mean arterial pressure <70 mmHg), brain tissue hypoxia (Pbt O2 < 20 mmHg), high intracranial pressure (>22 mmHg), low cerebral perfusion pressure (CPP <70 mmHg), and cerebral autoregulation pressure (pressure reactivity index [PRx]) during baseline (1 hour before) and 6 hours after medication were analyzed in febrile (core temperature; Tcore ≥ 38...
March 5, 2019: Therapeutic Hypothermia and Temperature Management
Natasha Liow, Paolo Montaldo, Peter J Lally, Justinas Teiserskas, Paul Bassett, Vânia Oliveira, Josephine Mendoza, Rebeccah Slater, Seetha Shankaran, Sudhin Thayyil
Although therapeutic hypothermia (TH) improves outcomes after neonatal encephalopathy (NE), the safety and efficacy of preemptive opioid sedation during cooling therapy is unclear. We performed a secondary analysis of the data from a large multicountry prospective observational study (Magnetic Resonance Biomarkers in Neonatal Encephalopathy [MARBLE]) to examine the association of preemptive morphine infusion during TH on brain injury and neurodevelopmental outcomes after NE. All recruited infants had 3.0 Tesla magnetic resonance imaging and spectroscopy at 1 week, and neurodevelopmental outcome assessments at 22 months...
February 26, 2019: Therapeutic Hypothermia and Temperature Management
Travis C Jackson, Patrick M Kochanek
Three decades of animal studies have reproducibly shown that hypothermia is profoundly cerebroprotective during or after a central nervous system (CNS) insult. The success of hypothermia in preclinical acute brain injury has not only fostered continued interest in research on the classic secondary injury mechanisms that are prevented or blunted by hypothermia but has also sparked a surge of new interest in elucidating beneficial signaling molecules that are increased by cooling. Ironically, while research into cold-induced neuroprotection is enjoying newfound interest in chronic neurodegenerative disease, conversely, the scope of the utility of therapeutic hypothermia (TH) across the field of acute brain injury is somewhat controversial and remains to be fully defined...
February 25, 2019: Therapeutic Hypothermia and Temperature Management
Jennifer Allen, Hope Kincaid, Elke Rockwell
Few studies have been done assessing the impact of palliative care on patients suffering cardiac arrest and requiring therapeutic hypothermia (TH). We conducted a retrospective cohort study to compare resource utilization and quality indicators among patients undergoing TH with and without palliative care consultation. Data were collected, over a two-year period, from the institutional international cardiac arrest registry database and electronic medical record review. One hundred twenty-nine patients were screened, 102 met inclusion criteria...
February 21, 2019: Therapeutic Hypothermia and Temperature Management
Kennosuke Tsuda, Sachiko Iwata, Takeo Mukai, Jun Shibasaki, Akihito Takeuchi, Tomoaki Ioroi, Hiroyuki Sano, Nanae Yutaka, Akihito Takahashi, Toshiki Takenouchi, Satoshi Osaga, Takuya Tokuhisa, Sachio Takashima, Hisanori Sobajima, Masanori Tamura, Shigeharu Hosono, Makoto Nabetani, Osuke Iwata
Therapeutic hypothermia following neonatal encephalopathy is neuroprotective. However, approximately one in two cooled infants still die or develop permanent neurological impairments. Further understanding of variables associated with the effectiveness of cooling is important to improve the therapeutic regimen. To identify clinical factors associated with short-term outcomes of cooled infants, clinical data of 509 cooled infants registered to the Baby Cooling Registry of Japan between 2012 and 2014 were evaluated...
March 2019: Therapeutic Hypothermia and Temperature Management
W Dalton Dietrich
No abstract text is available yet for this article.
February 13, 2019: Therapeutic Hypothermia and Temperature Management
Mary Kay Bader, Stephen A Figueroa, Claranne Mathiesen, Patricia Pat A Blissitt, Mary M Guanci, Leslie A Hamilton, Liz Fox, Teresa Wavra
No abstract text is available yet for this article.
February 6, 2019: Therapeutic Hypothermia and Temperature Management
María Arriaga-Redondo, Juan Arnaez, Isabel Benavente-Fernández, Simón Lubián-López, Montesclaros Hortigüela, Cristina Vega-Del-Val, Alfredo Garcia-Alix
Cerebral oximetry using near-infrared spectroscopy (NIRS) provides continuous, noninvasive assessment of the degree of hemoglobin saturation of the brain tissue. Previous studies suggest that high values of regional cerebral tissue oxygen saturation (rScO2 ) during the first days in neonates with significant hypoxic-ischemic encephalopathy (HIE) are correlated with an adverse neurological outcome. However, the results are not consistent among the studies. To examine the correlation of rScO2 values and their variability over time with HIE severity, amplitude integrated electroencephalography (aEEG) background and seizure activity, neuron-specific enolase levels in cerebrospinal fluid, magnetic resonance imaging (MRI) findings, and neurological outcome...
January 24, 2019: Therapeutic Hypothermia and Temperature Management
Faraaz Bhatti, Melissa Naiman, Alexander Tsarev, Erik Kulstad
Traumatic brain injury (TBI) is a leading cause of death in the United States, and represents 2.5 million Emergency Department attendances, admissions into hospital, and deaths. A range of temperature modulating devices have been used to proactively cool TBI patients; however, there are currently no uniform targeted temperature management (TTM) guidelines in this patient population. Esophageal temperature management (ETM) is a relatively new TTM modality and the purpose of this study is to determine whether ETM is effective in controlling core temperature in TBI cases...
January 18, 2019: Therapeutic Hypothermia and Temperature Management
Kees Polderman, Ahmed Hegazy, Justin Lundbye, Noel Watson
No abstract text is available yet for this article.
January 7, 2019: Therapeutic Hypothermia and Temperature Management
Michael C Kurz, Patrick Lyden, Michael Dae, Marko Noc
No abstract text is available yet for this article.
January 7, 2019: Therapeutic Hypothermia and Temperature Management
Juan Arnaez, María Miranda, Ester Riñones, Alfredo García-Alix
There is mounting experimental evidence that therapeutic hypothermia (TH) mitigates secondary mechanisms of spinal cord injury (SCI). There is a potential synergistic neuroprotective effect for SCI through the combination of TH and other promising therapies. The treatment of TH for SCI has promising results in adults, but its use is anecdotal in newborns with SCI. SCI is a rare, serious, and often fatal complication of instrumental delivery. For the first time, we describe the case of a male newborn infant with upper SCI who was born at term age and was offered whole-body cooling and erythropoietin treatment with unsuccessful outcome...
January 7, 2019: Therapeutic Hypothermia and Temperature Management
Sola Kim, Ki Ok Ahn, Young Sun Ro, Sang Do Shin
This study aimed to identify factors associated with the decision to transfer resuscitated patients with out-of-hospital cardiac arrest (OHCA) who were initially examined at hospitals with limited targeted temperature management capability (HLTC) in Korea. We included adult patients with OHCA who were initially transported to HLTC from 2012 to 2015. We limited the study population with OHCA who were admitted or transferred. Potential factors associated with the transfer decision were categorized as patient- or hospital-level characteristics...
December 26, 2018: Therapeutic Hypothermia and Temperature Management
Caroline Beaulieu, Lisa Kurczewski
Current American Heart Association/American Stroke Association guidelines for the management of spontaneous intracerebral hemorrhage suggest therapeutic hypothermia (TH) as a salvage therapy in patients with elevated intracranial pressure. Electrolyte disorders may develop at any stage of the cooling process. Such deregulation can place patients at an increased risk for arrhythmias and worsened neurologic outcomes. The impact of TH on serum electrolyte concentration has been described, but electrolyte changes and repletions are yet to be quantified...
December 26, 2018: Therapeutic Hypothermia and Temperature Management
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