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https://www.readbyqxmd.com/read/28652388/optimization-of-thermolytic-response-to-a1-adenosine-receptor-agonists-in-rats
#1
Isaac R Bailey, Bernard Laughlin, Lucille Moore, Lori K Bogren, Zeinab Barati, Kelly L Drew
Cardiac arrest is a leading cause of death in the United States and currently, therapeutic hypothermia, now called targeted temperature management (TTM), is the only recent treatment modality proven to increase survival rates and reduce morbidity for this condition. Shivering and subsequent metabolic stress, however, limits application and benefit of TTM. Stimulating CNS A1 adenosine receptors inhibits shivering and non-shivering thermogenesis in rats and induces a hibernation-like response in hibernating species...
June 26, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28648810/can-somatosensory-and-visual-evoked-potentials-predict-neurological-outcome-during-targeted-temperature-management-in-post-cardiac-arrest-patients
#2
Seung Pill Choi, Kyu Nam Park, Jung Hee Wee, Jeong Ho Park, Chun Song Youn, Han Joon Kim, Sang Hoon Oh, Yoon Sang Oh, Soo Hyun Kim, Joo Suk Oh
PURPOSES: In cardiac arrest patients treated with targeted temperature management (TTM), it is not certain if somatosensory evoked potentials (SEPs) and visual evoked potentials (VEPs) can predict neurological outcomes during TTM. The aim of this study was to investigate the prognostic value of SEPs and VEPs during TTM and after rewarming. METHODS: This retrospective cohort study included comatose patients resuscitated from cardiac arrest and treated with TTM between March 2007 and July 2015...
June 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#3
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28629741/establishment-of-an-ideal-time-window-model-in-hypothermic-targeted-temperature-management-after-traumatic-brain-injury-in-rats
#4
Wan-Yong Zhao, Shao-Bo Chen, Jing-Jing Wang, Chao Xu, Ming-Liang Zhao, Hua-Jiang Dong, Hai-Qian Liang, Xiao-Hong Li, Yue Tu, Sai Zhang, Chong Chen, Hong-Tao Sun
Although hypothermic-targeted temperature management (HTTM) holds great potential for the treatment of traumatic brain injury (TBI), translation of the efficacy of hypothermia from animal models to TBI patientshas no entire consistency. This study aimed to find an ideal time window model in experimental rats which was more in accordance with clinical practice through the delayed HTTM intervention. Sprague-Dawley rats were subjected to unilateral cortical contusion injury and received therapeutic hypothermia at 15 mins, 2 hours, 4 hours respectively after TBI...
June 16, 2017: Brain Research
https://www.readbyqxmd.com/read/28629472/protein-s100-as-outcome-predictor-after-out-of-hospital-cardiac-arrest-and-targeted-temperature-management-at-33%C3%A2-%C3%A2-c-and-36%C3%A2-%C3%A2-c
#5
Pascal Stammet, Josef Dankiewicz, Niklas Nielsen, François Fays, Olivier Collignon, Christian Hassager, Michael Wanscher, Johan Undèn, Jorn Wetterslev, Tommaso Pellis, Anders Aneman, Jan Hovdenes, Matt P Wise, Georges Gilson, David Erlinge, Janneke Horn, Tobias Cronberg, Michael Kuiper, Jesper Kjaergaard, Yvan Gasche, Yvan Devaux, Hans Friberg
BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28624592/post-anoxic-quantitative-mri-changes-may-predict-emergence-from-coma-and-functional-outcomes-at-discharge
#6
Alexandra S Reynolds, Xiaotao Guo, Elizabeth Matthews, Daniel Brodie, Leroy E Rabbani, David J Roh, Soojin Park, Jan Claassen, Mitchell S V Elkind, Binsheng Zhao, Sachin Agarwal
BACKGROUND: Traditional predictors of neurological prognosis after cardiac arrest are unreliable after targeted temperature management. Absence of pupillary reflexes remains a reliable predictor of poor outcome. Diffusion-weighted imaging has emerged as a potential predictor of recovery, and here we compare imaging characteristics to pupillary exam. METHODS: We identified 69 patients who had MRIs within seven days of arrest and used a semi-automated algorithm to perform quantitative volumetric analysis of apparent diffusion coefficient (ADC) sequences at various thresholds...
June 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28617423/relationship-between-temperature-variability-and-brain-injury-on-magnetic-resonance-imaging-in-cooled-newborn-infants-after-perinatal-asphyxia
#7
B Brotschi, R Gunny, C Rethmann, U Held, B Latal, C Hagmann
OBJECTIVE: The objective of the study was whether temperature management during therapeutic hypothermia correlates with the severity of brain injury assessed on magnetic resonance imaging in term infants with hypoxic-ischemic encephalopathy. STUDY DESIGN: Prospectively collected register data from the National Asphyxia and Cooling Register of Switzerland were analyzed. RESULT: Fifty-five newborn infants were cooled for 72 h with a target temperature range of 33 to 34 °C...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28610551/passive-cooling-of-cutaneous-and-subcutaneous-tissues-using-phase-changing-materials-feasibility-study-using-a-numerical-model
#8
Ricardo Romero-Méndez, Francisco G Pérez-Gutiérrez, Joseph J Musacchia, Walfre Franco
In many dermatological applications, lowering the temperature of skin and maintaining specific temperatures for extended periods of time are fundamental requirements for treatment; for example, in targeting adipose tissue and managing cutaneous pain. In this work we investigate the feasibility of using phase changing materials (PCMs) as an alternative passive, open-loop, heat extraction method for cooling cutaneous and subcutaneous tissues. We used a finite difference parametric approach to model the spatial and temporal progression of the heat transferred from the skin to a PCM in contact with the skin surface...
June 13, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28605928/targeted-temperature-management-after-out-of-hospital-cardiac-arrest-in-three-young-patients
#9
Amina Godinjak, Amer Iglica, Adis Kukuljac, Ira Tančica, Selma Jusufović, Anes Ajanović, Šejla Rožajac
OBJECTIVE: We present the use of targeted temperature management in a tertiary-level intensive care unit, in three patients who experienced an out-of-hospital cardiac arrest. CASE REPORT: Three young patients experienced an out-of-hospital non-coronary cardiac arrest. The causes of the cardiac arrest were: Wolf-Parkinson-White syndrome, drug overdose and long-QT syndrome. All patients were resuscitated according to the advanced cardiac life support guidelines, and treated with targeted temperature management, with a target temperature of 33°C for 24 hours...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28602694/prolonged-targeted-temperature-management-compromises-thrombin-generation-a-randomised-clinical-trial
#10
Anni Nørgaard Jeppesen, Anne-Mette Hvas, Christophe Henri Valdemar Duez, Anders Morten Grejs, Susanne Ilkjær, Hans Kirkegaard
AIM: To investigate whether prolonged compared with standard duration of targeted temperature management (TTM) compromises coagulation. METHODS: Comatose survivors after out-of-hospital cardiac arrest (n=82) were randomised to standard (24hours) or prolonged (48hours) duration of TTM at 33±1°C. Blood samples were drawn 22, 46 and 70hours after attaining the target temperature. Samples were analysed for rotational thromboelastometry (ROTEM(®) (EXTEM(®), INTEM(®), FIBTEM(®) and HEPTEM(®))) and thrombin generation using the Calibrated Automated Thrombogram(®) assay...
June 7, 2017: Resuscitation
https://www.readbyqxmd.com/read/28589506/pre-existing-medical-comorbidity-is-not-associated-with-neurological-outcomes-in-patients-undergoing-targeted-temperature-management-following-cardiac-arrest
#11
Arash Nayeri, Nirmanmoh Bhatia, Benjamin Holmes, Nyal Borges, Michael N Young, Quinn S Wells, John A McPherson
The prognostic significance of chronic medical illness in comatose survivors of cardiac arrest who undergo targeted temperature management (TTM) remains largely unknown. We sought to assess the association between overall burden of pre-existing medical comorbidity and neurological outcomes in survivors of cardiac arrest undergoing TTM. We analyzed a prospectively collected cohort of 314 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014. Overall burden of medical comorbidity was approximated with the use of the Charlson Comorbidity Index (CCI)...
June 6, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28581559/the-social-cost-of-methane-theory-and-applications
#12
D T Shindell, J S Fuglestvedt, W J Collins
Methane emissions contribute to global warming, damage public health and reduce the yield of agricultural and forest ecosystems. Quantifying these damages to the planetary commons by calculating the social cost of methane (SCM) facilitates more comprehensive cost-benefit analyses of methane emissions control measures and is the first step to potentially incorporating them into the marketplace. Use of a broad measure of social welfare is also an attractive alternative or supplement to emission metrics focused on a temperature target in a given year as it incentivizes action to provide benefits over a broader range of impacts and timescales...
June 5, 2017: Faraday Discussions
https://www.readbyqxmd.com/read/28557694/targeted-temperature-management-effectiveness-in-the-elderly-insights-from-a-large-registry
#13
Timothy J Mader, Lauren M Westafer, Brian H Nathanson, Nadia Villarroel, Ryan A Coute, Bryan F McNally
Targeted temperature management (TTM) is recommended for all comatose adult out-of-hospital cardiac arrest (OHCA) patients with shockable first documented rhythm. However, studies examining the use and benefits of TTM among patients aged 75 and older are lacking. Using the Cardiac Arrest Registry to Enhance Survival (CARES) dataset registry from 2013 to 2015. Study criteria included being 75 years of age or older, survival to hospital admission, and known in-hospital mortality and CPC (Cerebral Performance Categories Scale) Scores...
May 30, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28553848/implementation-of-targeted-temperature-management-after-cardiac-arrest-in-polish-intensive-care-units-what-has-changed-in-the-last-five-years
#14
Paweł Krawczyk, Anna Tarczyńska, Grzegorz Dziadek, Miłosz Gołębiowski, Andrzej A Kononowicz, Janusz Andres
BACKGROUND: Studies conducted up to 2010 indicate the underuse of targeted temperature management (TTM) in Poland. AIM: This study evaluated the current degree of TTM implementation in Polish intensive care units (ICUs) and analysed the implementation process since 2005. METHODS: A telephone survey, conducted from December 2014 to July 2015, was carried out to determine the number of ICUs using TTM in patients after cardiac arrest. We collected data on the details and prevalence of TTM, and the impact of organisational and financial issues and recently published papers on its use...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28536893/neurologic-recovery-after-cardiac-arrest-a-multifaceted-puzzle-requiring-comprehensive-coordinated-care
#15
REVIEW
Carolina B Maciel, Mary M Barden, David M Greer
Surviving cardiac arrest (CA) requires a longitudinal approach with multiple levels of responsibility, including fostering a culture of action by increasing public awareness and training, optimization of resuscitation measures including frequent updates of guidelines and their timely implementation into practice, and optimization of post-CA care. This clearly goes beyond resuscitation and targeted temperature management. Brain-directed physiologic goals should dictate the post-CA management, as accumulating evidence suggests that the degree of hypoxic brain injury is the main determinant of survival, regardless of the etiology of arrest...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28528323/c-graph-a-validated-scoring-system-for-early-stratification-of-neurologic-outcome-after-out-of-hospital-cardiac-arrest-treated-with-targeted-temperature-management
#16
Erich L Kiehl, Alex M Parker, Ralph M Matar, Matthew F Gottbrecht, Michelle C Johansen, Mark P Adams, Lori A Griffiths, Steven P Dunn, Katherine L Bidwell, Venu Menon, Kyle B Enfield, Lawrence W Gimple
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post-OHCA remains difficult in patients receiving targeted temperature management. METHODS AND RESULTS: Retrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32-34°C) for 24 hours at a tertiary-care center from 2008 to 2012 (development cohort, n=122)...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28506865/protocol-driven-neurological-prognostication-and-withdrawal-of-life-sustaining-therapy-after-cardiac-arrest-and-targeted-temperature-management
#17
Irina Dragancea, Matthew P Wise, Nawaf Al-Subaie, Julius Cranshaw, Hans Friberg, Guy Glover, Tommaso Pellis, Rebecca Rylance, Andrew Walden, Niklas Nielsen, Tobias Cronberg
BACKGROUND: Brain injury is reportedly the main cause of death for patients resuscitated after out-of-hospital cardiac arrest (OHCA). However, the majority may actually die following withdrawal of life-sustaining therapy (WLST) with a presumption of poor neurological recovery. We investigated how the protocol for neurological prognostication was used and how related treatment recommendations might have affected WLST decision-making and outcome after OHCA in the targeted temperature management (TTM) trial...
May 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#18
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 30, 2017: Neurology
https://www.readbyqxmd.com/read/28487973/benefits-of-anti%C3%A2-inflammatory-therapy-in-the-treatment-of-ischemia-reperfusion-injury-in-the-renal-microvascular-endothelium-of-rats-with-return-of-spontaneous-circulation
#19
Wei Wei, Yong Xie, Shi-Chao Lai, Bo-Fu Liu, Ya-Rong He, Hai Hu, Yu Cao
The aim of the present study was to investigate whether prostaglandin E1 (PGE1), target temperature management (TTM) and a combined intervention involving the two would be beneficial as anti‑inflammatory therapies for ischemia/reperfusion (I/R) injury to the renal microvascular endothelium of rats with return of spontaneous circulation (ROSC). In each group of rats with different interventions, following successful cardiopulmonary resuscitation, the levels of thrombomodulin (TM), interleukin‑6 (IL‑6) and tumor necrosis factor‑α (TNF‑α) in the plasma were evaluated...
June 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28476550/disseminated-intravascular-coagulation-is-associated-with-the-neurologic-outcome-of-cardiac-arrest-survivors
#20
Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Sung Min Lee, Yong Soo Cho, Seong-Woo Yun, Yong Il Min
PURPOSE: We aimed to examine the serial changes in coagulofibrinolytic markers that occurred after the restoration of spontaneous circulation (ROSC) in cardiac arrest patients, who were treated with targeted temperature management (TTM). We also evaluated the association between the disseminated intravascular coagulation (DIC) score and clinical outcomes. METHODS: This was a single-centre, retrospective observational study that included cardiac arrest patients who were treated with TTM from May 2012 to December 2015...
May 1, 2017: American Journal of Emergency Medicine
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