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Mild Systemic Hypothermia

Dorotea Ninković, Željka Mustapić, Dorotea Bartoniček, Vesna Benjak, Mario Ćuk, Andrea Dasović Buljević, Boris Filipović Grčić, Ksenija Fumić, Ruža Grizelj, Ivan Lehman, Danijela Petković Ramadža, Vladimir Sarnavka, Jasna Slaviček, Jasminka Stipanović Kastelić, Nina Barišić, Ivo Barić
BACKGROUND: Hyperammonemic encephalopathy in newborns with urea cycle disorders and certain organic acidurias can cause severe brain injury, coma and death. Standard therapy includes protein restriction, nitrogen-scavenging drugs, prevention of catabolism and hemodialysis. Neuroprotective hypothermia as part of the treatment has been reported only 3 times. It has been suggested that mild systemic hypothermia can contribute to better neurological outcomes in hyperammonemic encephalopathy...
March 2019: Klinische Pädiatrie
Andras Garami, Alexandre A Steiner, Andrej A Romanovsky
Systemic inflammation-associated syndromes (e.g., sepsis and septic shock) often have high mortality and remain a challenge in emergency medicine. Systemic inflammation is usually accompanied by changes in body temperature: fever or hypothermia. In animal studies, systemic inflammation is often modeled by administering bacterial lipopolysaccharide, which triggers autonomic and behavioral thermoeffector responses and causes either fever or hypothermia, depending on the dose and ambient temperature. Fever and hypothermia are regulated changes of body temperature, which correspond to mild and severe forms of systemic inflammation, respectively...
2018: Handbook of Clinical Neurology
Daniel C Schroeder, Alexandra C Maul, Maria Guschlbauer, Simon-Richard Finke, David de la Puente Bethencourt, Ingrid Becker, Stephan A Padosch, Andreas Hohn, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management is a standard therapy for unconscious survivors of cardiac arrest. To date, multiple cooling methods are available including invasive intravascular cooling devices (IVDs), which are widely used in the clinical setting. Recently, esophageal heat exchangers (EHEs) have been developed providing cooling via the esophagus that is located close to the aorta and inferior vena cava. The objective was to compare mean cooling rates, as well as differences, to target temperature during maintenance and the rewarming period of IVD and EHE...
November 9, 2018: Anesthesia and Analgesia
Liang Zhu
Despite more than 80 years of animal experiments and clinical practice, efficacy of hypothermia in improving treatment outcomes in patients suffering from cell and tissue damage caused by ischemia is still ongoing. This review will first describe the history of utilizing cooling in medical treatment, followed by chemical and biochemical mechanisms of cooling that can lead to neuroprotection often observed in animal studies and some clinical studies. The next sections will be focused on current cooling approaches/devices, as well as cooling parameters recommended by researchers and clinicians...
2018: Advances in Experimental Medicine and Biology
Yangyang Zou, Limin Chen, Tianfeng Hua, Min Yang
OBJECTIVE: To investigate the protective function of endovascular cooling method on post-resuscitation syndrome (PRS) in porcine cardiac arrest (CA) model and its mechanism. METHODS: Ventricular fibrillation (VF) was electrically induced and untreated for 8 minutes in 15 healthy male porcines, cardiopulmonary resuscitation (CPR) was then initiated. All successful recovery animals were randomly divided into two groups by random number table. In normal temperature group, the core temperature was maintained at (38...
September 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Eduardo A Saramago, Gabriela S Borges, Carlitos G Singolani-Jr, Jonatas E Nogueira, Renato N Soriano, Evelin C Cárnio, Luiz G S Branco
Molecular hydrogen (H2 ) exerts anti-oxidative, anti-apoptotic, and anti-inflammatory effects. Here we tested the hypothesis that H2 modulates cardiovascular, inflammatory, and thermoregulatory changes in systemic inflammation (SI) induced by lipopolysaccharide (LPS) at different doses (0.1 or 1.5 mg/kg, intravenously, to induce mild or severe SI) in male Wistar rats (250-300 g). LPS or saline was injected immediately before the beginning of 360-minute inhalation of H2 (2% H2 , 21% O2 , balanced with nitrogen) or room air (21% O2 , balanced with nitrogen)...
September 24, 2018: Brain, Behavior, and Immunity
Kai Zhao, Rui Li, Sheng Bi, Yu Li, Long Liu, Yu-Long Jia, Peng Han, Chang-Cong Gu, Xi-Ze Guo, Wan-Ping Zhang, Chun Wang, Chun-Ying Pei, Lin-Lu Tian, Li-Xian Li
Mild therapeutic hypothermia has been shown to mitigate cerebral ischemia, reduce cerebral edema, and improve the prognosis of patients with cerebral ischemia. Adipose-derived stem cell-based therapy can decrease neuronal death and infiltration of inflammatory cells, exerting a neuroprotective effect. We hypothesized that the combination of mild therapeutic hypothermia and adipose-derived stem cells would be neuroprotective for treatment of stroke. A rat model of transient middle cerebral artery occlusion was established using the nylon monofilament method...
October 2018: Neural Regeneration Research
Michel Roethlisberger, Lara Gut, Daniel Walter Zumofen, Urs Fisch, Oliver Boss, Nicolai Maldaner, Davide Marco Croci, Ethan Taub, Natascia Corti, Jan-Karl Burkhardt, Raphael Guzman, Oliver Bozinov, Luigi Mariani
OBJECTIVE Women taking combined hormonal contraceptives (CHCs) are generally considered to be at low risk for cerebral venous thrombosis (CVT). When it does occur, however, intensive care and neurosurgical management may, in rare cases, be needed for the control of elevated intracranial pressure (ICP). The use of nonsurgical strategies such as barbiturate coma and induced hypothermia has never been reported in this context. The objective of this study is to determine predictive factors for invasive or surgical ICP treatment and the potential complications of nonsurgical strategies in this population...
July 2018: Neurosurgical Focus
Gary J Hodges, Steven Ah Ferguson, Stephen S Cheung
This study examined the effect of mild hypothermia (a 0.5°C decrease in rectal temperature) on heart rate variability (HRV), with the identical hypothermia protocol performed twice and compared using intraclass correlation coefficient (r) analysis to study the repeatability. Twelve healthy males each completed a Neutral (23°C) and two Cold (0°C) trials. In the Neutral trial participants sat quietly for 30 min. In the Cold trials, baseline data were obtained from a 5-min sample following 30 min of quiet sitting at 23°C, followed by passive exposure to 0°C; hypothermic measures were taken from a 5-min period immediately prior to rectal temperature decreasing by 0...
June 26, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Hong Zhang, Dominique M Lund, Haley A Ciccone, William D Staatz, Mohab M Ibrahim, Tally M Largent-Milnes, Herbert H Seltzman, Igor Spigelman, Todd W Vanderah
Many malignant cancers, including breast cancer, have a propensity to invade bones, leading to excruciating bone pain. Opioids are the primary analgesics used to alleviate this cancer-induced bone pain (CIBP) but are associated with numerous severe side effects, including enhanced bone degradation, which significantly impairs patients' quality of life. By contrast, agonists activating only peripheral CB1 receptors (CB1Rs) have been shown to effectively alleviate multiple chronic pain conditions with limited side effects, yet no studies have evaluated their role(s) in CIBP...
September 2018: Pain
Zhijun Li
Tianjin, as the earliest city to open up, the exchange of Chinese and Western cultures also started earlier. Therefore, today's emergency medicine system with integrated features of Chinese and Western medicine is formed. Professor Wang Jinda, who works in Tianjin First Center Hospital, makes the theory of "treating bronchitis and treating diseases" and "three methods of three syndromes" for the treatment of severe diseases such as sepsis. The surgical aspect is the treatment of acute abdomen with the combination of Chinese and Western medicine which is proposed by Academician Wu Xianzhong who worked in Tianjin Nankai Hospital...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Bo Mei, Song Yang, Yuan Yue, Jian Hou, Keke Wang, Guangxian Chen, Mengya Liang, Zhongkai Wu
OBJECTIVE: Cardiopulmonary bypass (CPB) might induce systemic inflammatory responses that cause acute injuries to multiple organs. However, no direct evidence exists to determine whether CPB leads to adrenal cortex injury or to describe its underlying mechanism. METHODS: Twelve healthy adult beagles were randomly assigned into control and CPB groups. After cannulation, mild hypothermia CPB was performed in the CPB group but not in the control group. The serum concentrations of various cytokines, cortisol, and aldosterone were assessed...
August 2018: Journal of Thoracic and Cardiovascular Surgery
Anne Brücken, Christian Bleilevens, Philipp Berger, Kay Nolte, Nadine T Gaisa, Rolf Rossaint, Gernot Marx, Matthias Derwall, Michael Fries
Guidelines endorse targeted temperature management to reduce neurological sequelae and mortality after cardiac arrest (CA). Additional therapeutic approaches are lacking. Inhaled nitric oxide (iNO) given post systemic ischemia/reperfusion injury improves outcomes. Attenuated inflammation by iNO might be crucial in brain protection. iNO augmented mild therapeutic hypothermia (MTH) may improve outcome after CA exceeding the effect of MTH alone. Following ten minutes of CA and three minutes of cardiopulmonary resuscitation, 20 male Sprague-Dawley rats were randomized to receive MTH at 33 °C for 6hrs or MTH + 20ppm iNO for 5hrs; one group served as normothermic control...
April 30, 2018: Scientific Reports
Kattri-Liis Eskla, Rando Porosk, Riin Reimets, Tanel Visnapuu, Eero Vasar, Christian Ansgar Hundahl, Hendrik Luuk
Mild hypothermia (32 °C) is routinely used in medical practice to alleviate hypoxic ischemic damage, however, the mechanisms that underlie its protective effects remain uncertain. Using a systems approach based on genome-wide expression screens, reporter assays and biochemical studies, we find that cellular hypothermia response is associated with the augmentation of major stress-inducible transcription factors Nrf2 and HIF1Α affecting the antioxidant system and hypoxia response pathways, respectively. At the same time, NF-κB, a transcription factor involved in the control of immune and inflammatory responses, was not induced by hypothermia...
June 2018: Free Radical Biology & Medicine
Qinghua Li, Rongqing Sun, Hongdi Lyu, Dexin Shen, Qing Hu, Haiwei Wang, Nannan Wang, Jin Yan, Jing Wang
OBJECTIVE: To investigate the protective effect of mild hypothermia at different starting times on the physiological functions of the viscera of exertional heat stroke (EHS). METHODS: A prospective randomized controlled trial was conducted. EHS patients admitted to intensive care unit of the 159th Hospital of People's Liberation Army and the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were enrolled. The patients were divided into 2, 4, 6 hours start hypothermia treatment groups according to the random number table method, the mild hypothermia was initiated at 2, 4 and 6 hours after the disease onset respectively, and the methods were the same in each group...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Martin Manninger, Alessio Alogna, David Zweiker, Birgit Zirngast, Stefan Reiter, Viktoria Herbst, Heinrich Maechler, Burkert M Pieske, Frank R Heinzel, Helmut Brussee, Heiner Post, Daniel Scherr
OBJECTIVE: Application of therapeutic mild hypothermia in patients after resuscitation, often accompanied by myocardial infarction, cardiogenic shock, and systemic inflammation may impact on cardiac rhythm. We therefore tested susceptibility to atrial arrhythmias during hyperthermia (HT, 40.5°C), normothermia (NT, 38.0°C), and mild hypothermia (MH, 33.0°C). METHODS: Nine healthy, anesthetized closed-chest landrace pigs were instrumented with a quadripolar stimulation catheter in the high right atrium and a decapolar catheter in the coronary sinus...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
Shannon E Currie
Heterothermic animals regularly undergo profound alterations of cardiac function associated with torpor. These animals have specialised tissues capable of withstanding fluctuations in body temperature > 30 °C without adverse effects. In particular, the hearts of heterotherms are able to resist fibrillation and discontinuity of the cardiac conduction system common in homeotherms during hypothermia. To investigate the patterns of cardiac conduction in small insectivorous bats which enter torpor year round, I simultaneously measured ECG and subcutaneous temperature (Tsub ) of 21 Nyctophilus gouldi (11 g) during torpor at a range of ambient temperatures (Ta 1-28 °C)...
July 2018: Journal of Comparative Physiology. B, Biochemical, Systemic, and Environmental Physiology
Jin Chen, Lingling Xie, Yue Hu, Xinghui Lan, Li Jiang
Little is known about pediatric patients suffering from nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) cessation. The aim of this study was to identify in pediatric patients the clinical characteristics of NCSE after CSE cessation and the factors that contribute to patient outcomes. Data from clinical features, electroencephalography (EEG) characteristics, neuroimaging findings, treatments, and prognosis were systematically summarized, and the associations between clinical characteristics and prognosis were quantified...
May 2018: Epilepsy & Behavior: E&B
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
September 2018: Therapeutic Hypothermia and Temperature Management
Mauro Torres, Roberto Zúñiga, Matias Gutierrez, Mauricio Vergara, Norberto Collazo, Juan Reyes, Julio Berrios, Juan Carlos Aguillon, Maria Carmen Molina, Claudia Altamirano
Chinese hamster ovary (CHO) cells are the most frequently used host for commercial production of therapeutic proteins. However, their low protein productivity in culture is the main hurdle to overcome. Mild hypothermia has been established as an effective strategy to enhance protein specific productivity, although the causes of such improvement still remain unclear. The self-regulation of global transcriptional regulatory factors, such as Myc and XBP1s, seems to be involved in increased the recombinant protein production at low temperature...
2018: PloS One
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