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Therapeutic Hypothermia and Temperature Management

Marko Noc, Hans Friberg, Chien-Hua Huang, Philip E Empey
No abstract text is available yet for this article.
November 9, 2018: Therapeutic Hypothermia and Temperature Management
Pascal Udekwu, Rhonda Vincent, Debra Petrarca, Meagan Farrell, Sara Roy
Favorable neurologic outcomes have been reported in near-hanging (NH) victims treated with therapeutic hypothermia (TH), but variable methods and small samples sizes limit interpretability. This study examines the relationship between clinical predictors, TH, and outcomes in NH patients. A risk profile was created by examining relationships between variables. Categorical predictors were assessed with chi-square tests and continuous variables were assessed with t-tests. Logistic regression was conducted to evaluate the unique effect of TH...
October 30, 2018: Therapeutic Hypothermia and Temperature Management
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
To investigate the different effects of mild hypothermia on pathological and physiological stress conditions in piglets, 30 pigs were randomized into four groups: cardiac arrest and mild hypothermia (CA-MH group), cardiac arrest and normothermia (CA-NH group), non-CA-MH (NCA-MH group), and a sham operation. The same hypothermia intervention was implemented in both CA-MH and NCA-MH groups. The CA-NH group did not undergo therapeutic hypothermia after resuscitation. The hemodynamic parameters were recorded. Cerebral metabolism variables and neurotransmitters in the extracellular fluid were collected through microdialysis tubes...
September 21, 2018: Therapeutic Hypothermia and Temperature Management
Fabrizio R Assis, M Emma G Bigelow, Raghuram Chava, Sunjeet Sidhu, Aravindan Kolandaivelu, Henry Halperin, Harikrishna Tandri
Targeted temperature management (TTM) is recommended as a standard of care for postcardiac arrest patients. Current TTM methods have significant limitations to be used in an ambulatory setting. We investigated the efficacy and safety of a novel noninvasive transnasal evaporative cooling device (CoolStat™). Eleven Yorkshire pigs underwent hypothermia therapy using the CoolStat device. CoolStat induces evaporative cooling by blowing dehumidified ambient air over the nasal turbinates in a unidirectional fashion...
September 20, 2018: 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...
September 19, 2018: Therapeutic Hypothermia and Temperature Management
Miyuki Tauchi, Maria Mercedes Tejada de Rink, Hiroshi Fujioka, Satoko Okayama, Kei-Ichiro Nakamura, Barbara Dietel, Stephan Achenbach, Rainer Kollmar, Stefan Schwab, Kazuo Ushijima, Hideki Harada
Targeted temperature management (TTM), or therapeutic hypothermia, is one of the most potent neuroprotective approaches after ischemic and traumatic brain injuries. TTM has been applied clinically with various methods, but effective achievement and maintenance of the target temperature remain challenging. Furthermore, timing of cooling and target body and brain temperature to optimize effectiveness for neuroprotection and to minimize side effects are yet to be standardized. Focal brain cooling is a potential strategy to minimize adverse effects of systemic TTM...
September 8, 2018: Therapeutic Hypothermia and Temperature Management
Minjung Kathy Chae, Sung Eun Lee, So Young Kang, Min Seob Sim
For better care of postcardiac arrest patients, objective serial assessments of brain injury severity are needed. We hypothesized that monitoring of cerebral energy metabolism based on arterio-jugular (AJ) differences of metabolites will provide serial details of brain injury and information about neurologic outcomes in patients. Measurements of lactate and glucose in addition to blood gas analyses were done every 6 hours from the radial artery and jugular bulb in postcardiac arrest patients throughout targeted temperature management (TTM)...
August 20, 2018: Therapeutic Hypothermia and Temperature Management
Thomas R Keeble, Michelle Gossip, Makayla Cordoza, Michelle Deckard, Noel Watson
No abstract text is available yet for this article.
September 2018: Therapeutic Hypothermia and Temperature Management
W Dalton Dietrich
No abstract text is available yet for this article.
September 2018: Therapeutic Hypothermia and Temperature Management
Patrick Lyden, Jonathan Paul, Shoji Yokobori, Joseph Cuschieri
No abstract text is available yet for this article.
September 2018: Therapeutic Hypothermia and Temperature Management
Sarah L Livesay, Leslie A Hamilton, William D Cahoon, Stephen A Figueroa, Dawn Gonzales Lovejoy, J J Baumann, Nicole Kupchik
No abstract text is available yet for this article.
September 2018: Therapeutic Hypothermia and Temperature Management
Se Hyun Oh, Hui Dong Kang, Sang Ku Jung, Sangchun Choi
Cerebral arterial gas embolism (CAGE) shows various manifestations according to the quantity of gas and the brain areas affected. The symptoms range from minor motor weakness, headache, and confusion to disorientation, convulsions, hemiparesis, unconsciousness, and coma. A 46-year-old man was transferred to our emergency department due to altered sensorium. Immediately after a controlled ascent from 33 m of seawater, he complained of shortness of breath and rigid extremities, lapsing into unconsciousness...
September 2018: Therapeutic Hypothermia and Temperature Management
Fritz-Patrick Jahns, Antonine Pineau Mitchell, Georg Auzinger
Hyperpyrexia is a well-documented adverse effect of 3,4-methylenedioxymethamphetamine (MDMA) and is associated with a poor prognosis. There are currently limited published records of patients surviving a pyrexia of or greater than 43°C after MDMA intake. Rapid cooling and multiorgan support in an intensive care setting may offer patients the best chance of recovery. We present the case of a 16-year-old male who was admitted to our tertiary, adult intensive care unit (ICU) for unrecordable pyrexia (>43°C) after reported ecstasy intake...
September 2018: Therapeutic Hypothermia and Temperature Management
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
Won Joo Jeong, Jae Seung Bang, Kyu Sun Yum, Sangkil Lee, Inyoung Chung, O-Ki Kwon, Chang Wan Oh, Beom Joon Kim, Hee-Joon Bae, Moon-Ku Han
Brain herniation is most often the result of severe brain swelling and can rapidly lead to death or brain death. We retrospectively identified radiologic indicators to evaluate the effects of targeted temperature management (TTM) on the extent of cerebral edema and determine the cutoff values that best predict TTM outcomes in patients with large hemispheric infarction. We retrospectively reviewed brain computed tomography (CT) scans of 21 patients with large hemispheric infarctions, who were treated with TTM...
September 2018: Therapeutic Hypothermia and Temperature Management
Artem Pastukhov, Tatiana Borisova
Deep and profound hypothermia is successfully practiced in the prevention of ischemic stroke consequences and aortic arch cardiac surgery accompanied by reduction of cerebral circulation. Hypothermia is a current neuroprotection standard in hypoxic/ischemic encephalopathy. Drug-hypothermia administration is proposed as a new approach in pharmacotherapy for neonatal seizures. Also, hypothermia is useful as neuroprotective approach in long-term interplanetary space missions. We recently revealed gradual dynamics of hypothermia-induced decrease in transporter-mediated release and uptake of L-[14 C]glutamate in presynaptic rat brain nerve terminals (synaptosomes), thereby confirming potent unspecific neuroprotective effect of hypothermia...
September 2018: Therapeutic Hypothermia and Temperature Management
Harald A Bergan, Per S Halvorsen, Andreas Espinoza, Viesturs Kerans, Helge Skulstad, Erik Fosse, Jan F Bugge
Therapeutic hypothermia is an established treatment in patients resuscitated from cardiac arrest. It is usually well-tolerated circulatory, but hypothermia negatively effects myocardial contraction and relaxation velocities and increases diastolic filling restrictions. A significant proportion of resuscitated patients are treated with long-acting beta-receptor blocking agents' prearrest, but the combined effects of hypothermia and beta-blockade on left ventricle (LV) function are not previously investigated...
September 2018: Therapeutic Hypothermia and Temperature Management
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takashi Kawamura, Takeshi Shimazu, Tetsuhisa Kitamura
To assess whether serum albumin concentration measured upon hospital arrival was useful as an early prognostic biomarker for neurologically favorable outcome in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM). This prospective, multicenter observational study (The CRITICAL Study) carried out between July 1, 2012 and December 31, 2014 in Osaka Prefecture, Japan involving 13 critical care medical centers (CCMCs) and one non-CCMC with an emergency department. This study included patients ≥18 years of age who underwent an OHCA, for whom resuscitation was attempted by Emergency Medical Services personnel and were then transported to participating institutions, and who were then treated with TTM...
September 2018: Therapeutic Hypothermia and Temperature Management
Misa Fister, Rihard Knafelj, Peter Radsel, Marko Zlicar, Tomaz Goslar, Marko Noc
We describe a patient with severe accidental hypothermia (≤25.4°C) and prolonged refractory ventricular fibrillation, lasting at least 4 hours and 8 minutes, who underwent cardiopulmonary resuscitation with extracorporeal membrane oxygenation and survived without neurologic deficit.
August 10, 2018: Therapeutic Hypothermia and Temperature Management
Alois J Schiefecker, Verena Rass, Maxime Gaasch, Mario Kofler, Claudius Thomé, Christian Humpel, Bogdan Ianosi, Werner O Hackl, Ronny Beer, Bettina Pfausler, Erich Schmutzhard, Raimund Helbok
In patients with aneurysmal subarachnoid hemorrhage (aSAH), increased brain extracellular interleukin (IL)-6 levels measured by cerebral microdialysis (CMD) were associated with disease severity, early brain injury, delayed cerebral infarction, and axonal injury. In this study, we analyzed brain extracellular IL-6 levels of aSAH patients following parenteral diclofenac. Twenty-four mechanically ventilated poor-grade aSAH patients were included. Changes in cerebral metabolism, brain/body temperature, and CMD-IL-6 levels following intravenous diclofenac infusion (DCF; 75 mg diluted in 100 cc normal saline) were retrospectively analyzed from prospectively collected bedside data (at 1 hour before DCF = baseline; and at 2, 4, and 8 hours after DCF)...
August 3, 2018: Therapeutic Hypothermia and Temperature Management
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