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THERAPEUTIC Temperature Management

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https://www.readbyqxmd.com/read/30072782/slow-rewarming-improved-the-neurological-outcomes-of-prolonged-mild-therapeutic-hypothermia-in-patients-with-severe-traumatic-brain-injury-and-an-evacuated-hematoma
#1
Tadashi Kaneko, Motoki Fujita, Susumu Yamashita, Yasutaka Oda, Eiichi Suehiro, Kenji Dohi, Shunji Kasaoka, Yasuhiro Kuroda, Hitoshi Kobata, Tsuyoshi Maekawa
Mild therapeutic hypothermia (MTH) is expected to improve the neurological outcomes of patients with severe traumatic brain injury (TBI). However, there are no standard protocols for managing the temperature of patients with severe TBI in order to improve their neurological outcomes. We conducted a post hoc analysis of the B-HYPO study, a randomized controlled trial of MTH in patients with TBI in Japan. We evaluated the impact of MTH methods on neurological outcomes. Ninety-seven patients who received MTH were included in the present analyses...
August 2, 2018: Scientific Reports
https://www.readbyqxmd.com/read/30067455/clinical-q-a-translating-therapeutic-temperature-management-from-theory-to-practice
#2
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.
August 1, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/30001950/development-and-external-validation-of-an-early-prognostic-model-for-survivors-of-out-of-hospital-cardiac-arrest
#3
Alberto Pérez-Castellanos, Manuel Martínez-Sellés, Aitor Uribarri, Carolina Devesa-Cordero, José Carlos Sánchez-Salado, Albert Ariza-Solé, Iago Sousa, Miriam Juárez, Francisco Fernández-Avilés
INTRODUCTION AND OBJECTIVES: Despite therapeutic hypothermia, unconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Our objective was to assess the usefulness of the variables obtained in the early moments after resuscitation in the prediction of 6-month prognosis. METHODS: A multicenter study was performed in 3 intensive cardiac care units. The analysis was done in 153 consecutive survivors of out-of-hospital cardiac arrest who underwent targeted temperature management between January 2007 and July 2015...
July 9, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29993335/successful-therapeutic-hypothermia-in-a-propofol-related-cardiac-arrest-case-a-case-report-and-literature-review
#4
Hamit Yildiz
Targeted temperature management (therapeutic hypothermia) is a treatment method used to prevent potential complications that can develop in relation to the increased temperature in the brain as a result of cardiac arrest. Due to costs and various health policies there is no comprehensive study in the world that has been able to guide the relevant literature on therapeutic hypothermia. We have presented a 25-year-old female patient in our study who developed cardiac arrest after the administration of propofol for sedation before undergoing a diagnostic upper gastroscopy procedure and received a successful therapeutic hypothermia therapy following a resuscitation of 19 minutes...
July 11, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29988664/the-profile-of-japanese-association-for-acute-medicine-out-of-hospital-cardiac-arrest-registry-in-2014-2015
#5
Tetsuhisa Kitamura, Taku Iwami, Takahiro Atsumi, Tomoyuki Endo, Tomoo Kanna, Yasuhiro Kuroda, Atsushi Sakurai, Osamu Tasaki, Yoshio Tahara, Ryosuke Tsuruta, Jun Tomio, Kazuyuki Nakata, Sho Nachi, Mamoru Hase, Mineji Hayakawa, Takahiro Hiruma, Kenichi Hiasa, Takashi Muguruma, Takao Yano, Takeshi Shimazu, Naoto Morimura
Aim: To describe the registry design of the Japanese Association for Acute Medicine - out-of-hospital cardiac arrest (JAAM-OHCA) Registry as well as its profile on hospital information, patient and emergency medical service characteristics, and in-hospital procedures and outcomes among patients with OHCA who were transported to the participating institutions. Methods: The special committee aiming to improve the survival after OHCA by providing evidence-based therapeutic strategies and emergency medical systems from the JAAM has launched a multicenter, prospective registry that enrolled OHCA patients who were transported to critical care medical centers or hospitals with an emergency care department...
July 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29880020/antiepileptic-drugs-in-critically-ill-patients
#6
REVIEW
Salia Farrokh, Pouya Tahsili-Fahadan, Eva K Ritzl, John J Lewin, Marek A Mirski
BACKGROUND: The incidence of seizures in intensive care units ranges from 3.3% to 34%. It is therefore often necessary to initiate or continue anticonvulsant drugs in this setting. When a new anticonvulsant is initiated, drug factors, such as onset of action and side effects, and patient factors, such as age, renal, and hepatic function, should be taken into account. It is important to note that the altered physiology of critically ill patients as well as pharmacological and nonpharmacological interventions such as renal replacement therapy, extracorporeal membrane oxygenation, and target temperature management may lead to therapeutic failure or toxicity...
June 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29794269/wireless-peripheral-nerve-stimulation-for-complex-regional-pain-syndrome-type-i-of-the-upper-extremity-a-case-illustration-introducing-a-novel-technology
#7
Daniel Herschkowitz, Jana Kubias
Background Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities...
July 26, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29762083/independent-risk-factors-for-the-shivering-occurrence-during-induction-period-in-out-of-hospital-cardiac-arrest-survivors-treated-with-targeted-temperature-management
#8
Youn-Jung Kim, Jin Mi Park, Min Soo Kim, Seung Mok Ryoo, Young Soon Park, Sung Sook Kim, Yeo Ok Kim, Won Young Kim
The occurrence of shivering during the induction period of targeted temperature management (TTM) remains a therapeutic obstacle, which delays the achievement of target temperature. The aim of this study was to identify risk factors leading to shivering during the induction period. We analyzed a prospective cohort of adult out-of-hospital cardiac arrest (OHCA) survivors treated with TTM from January 2015 to June 2017. Patients who developed shivering during the induction period were compared to those who did not...
May 15, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29742037/clinical-q-a-translating-therapeutic-temperature-management-from-theory-to-practice
#9
Michelle Hill, William D Cahoon, Mary McKenna Guanci, Patricia A Blissitt, Leslie A Hamilton
No abstract text is available yet for this article.
June 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29737259/refractory-out-of-hospital-cardiac-arrest
#10
Madhan Shanmugasundaram, Kapildeo Lotun
Refractory out of hospital cardiac arrest is a common problem that is associated with poor overall survival rates and neurological outcomes. There are various definitions that have been used but the most accepted one is cardiac arrest that requires more than 10 minutes of Cardiopulmonary Resuscitation (CPR) efforts or more than 3 defibrillation attempts. There have been different pharmacologic and non-pharmacologic therapies that were studied in these patients. None of the antiarrhythmic or vasopressor medications have been consistently shown to improve survival or neurological outcomes in this subset of patients...
2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29713000/effects-of-inhaled-nitric-oxide-on-outcome-after-prolonged-cardiac-arrest-in-mild-therapeutic-hypothermia-treated-rats
#11
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
https://www.readbyqxmd.com/read/29684622/injectable-drug-depot-engineered-to-release-multiple-ophthalmic-therapeutic-agents-with-precise-time-profiles-for-postoperative-treatment-following-ocular-surgery
#12
Maziar Mohammadi, Kisha Patel, Seyedeh P Alaie, Ron B Shmueli, Cagri G Besirli, Ronald G Larson, Jordan J Green
A multi-drug delivery platform is developed to address current shortcomings of post-operative ocular drug delivery. The sustained biodegradable drug release system is composed of biodegradable polymeric microparticles (MPs) incorporated into a bulk biodegradable hydrogel made from triblock copolymers with poly(ethylene glycol) (PEG) center blocks and hydrophobic biodegradable polyester blocks such as poly(lactide-co-glycolide) (PLGA), Poly(lactic acid) (PLA), or Poly(lactide-co-caprolactone) (PLCL) blocks. This system is engineered to flow as a liquid solution at room temperature for facile injection into the eye and then quickly gel as it warms to physiological body temperatures (approximately 37 °C)...
June 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29677083/east-multicenter-trial-on-targeted-temperature-management-for-hanging-induced-cardiac-arrest
#13
Cindy H Hsu, Bryce E Haac, Mack Drake, Andrew C Bernard, Alberto Aiolfi, Kenji Inaba, Holly E Hinson, Chinar Agarwal, Joseph Galante, Emily M Tibbits, Nicholas J Johnson, David Carlbom, Mina F Mirhoseini, Mayur B Patel, Karen R OʼBosky, Christian Chan, Pascal O Udekwu, Megan Farrell, Jeffrey L Wild, Katelyn A Young, Daniel C Cullinane, Deborah J Gojmerac, Alexandra Weissman, Clifton Callaway, Sarah M Perman, Mariana Guerrero, Imoigele P Aisiku, Raghu R Seethala, Ivan N Co, Debbie Y Madhok, Bryan Darger, Dennis Y Kim, Lara Spence, Thomas M Scalea, Deborah M Stein
BACKGROUND: We sought to determine the outcome of suicidal hanging and the impact of targeted temperature management (TTM) on hanging-induced cardiac arrest (CA) through an Eastern Association for the Surgery of Trauma (EAST) multicenter retrospective study. METHODS: We analyzed hanging patient data and TTM variables from January 1992 to December 2015. Cerebral performance category score of 1 or 2 was considered good neurologic outcome, while cerebral performance category score of 3 or 4 was considered poor outcome...
July 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29600828/an-electrical-plasma-dissection-tool-for-surgical-treatment-of-chronic-ulcers-results-of-a-prospective-randomised-trial
#14
Giovanni F Marangi, Tiziano Pallara, Daniela Lamberti, Eleonora Perrella, Raffaele Serra, Francesco Stilo, Giovanni De Caridi, Andrea Onetti Muda, Paolo Persichetti
Cutaneous ulceration is a difficult medical problem and a major source of morbidity for patients. In the surgical treatment of ulcers, debridement is the first step, and it can be carried out using several surgical tools. Recently, new surgical devices have emerged using plasma-mediated electrical discharges with a lower peak temperature. A prospective single-blind trial was conducted on chronic ulcers not responsive to common non-surgical management. Patients were randomly separated into 2 groups: Group A received surgical debridement with conventional electrocautery, and Group B received surgical debridement using the plasma-mediated device...
March 30, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#15
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...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29534742/the-efficacy-and-safety-of-pre-hospital-cooling-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#16
Patrick J Lindsay, Danielle Buell, Damon C Scales
BACKGROUND: Mild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating TH for all eligible individuals presenting with OHCA; however, the timing of cooling initiation remains uncertain. This systematic review and meta-analysis was conducted with all available randomised controlled trials (RCTs) included to explore the efficacy and safety of initiating pre-hospital TH in patients with OHCA...
March 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29494366/targeted-temperature-management-for-improved-outcomes-are-we-there-yet
#17
REVIEW
Micaela Carwell
Therapeutic hypothermia, also referred to as targeted temperature management, has been a component of the postcardiac arrest treatment guidelines since 2010. Although almost a decade has passed since its inclusion in the postarrest guidelines, many unanswered questions remain regarding selection of the appropriate patient population, optimal target temperature, ideal window of time in which to initiate therapy after arrest, most efficient, safe, and accurate equipment choice for inducing and maintaining hypothermia, most effective duration of treatment, and rate of cooling or rewarming...
April 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29485712/antinociceptive-effect-of-two-novel-transient-receptor-potential-melastatin-8-antagonists-in-acute-and-chronic-pain-models-in-rat
#18
Carmen De Caro, Roberto Russo, Carmen Avagliano, Claudia Cristiano, Antonio Calignano, Andrea Aramini, Gianluca Bianchini, Marcello Allegretti, Laura Brandolini
BACKGROUND AND PURPOSE: Transient receptor potential (TRP) channels are a superfamily of non-selective cation permeable channels involved in peripheral sensory signalling. Animal studies have shown that several TRPs are important players in pain modulation. Among them, the TRP melastatin 8 (TRPM8) has elicited more interest for its controversial role in nociception. This channel, expressed by a subpopulation of sensory neurons in dorsal root ganglia (DRG) and trigeminal ganglia (TG), is activated by cold temperatures and cooling agents...
May 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29468430/impaired-aspirin-mediated-platelet-function-inhibition-in-resuscitated-patients-with-acute-myocardial-infarction-treated-with-therapeutic-hypothermia-a-prospective-observational-non-randomized-single-centre-study
#19
Florian Prüller, Oliver Leopold Milke, Lukasz Bis, Friedrich Fruhwald, Daniel Scherr, Philipp Eller, Sascha Pätzold, Siegfried Altmanninger-Sock, Peter Rainer, Jolanta Siller-Matula, Dirk von Lewinski
The majority of resuscitated patients present with underlying cardiac disease, and out of these myocardial infarction is most common. Immediate interventional treatment is recommended and routinely requires dual antiplatelet therapy including aspirin and a P2Y12-inhibitor. Therapeutic hypothermia or target temperature management is also recommended in these patients. Cardiogenic shock as well as reduced body temperature impacts platelet reactivity and its medical inhibition. The study aims to quantify aspirin- and P2Y12-mediated platelet inhibition in patients presenting with myocardial infarction and cardiopulmonary resuscitation...
February 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29404061/development-of-a-novel-stability-indicating-rp-hplc-method-for-quantification-of-connexin43-mimetic-peptide-and-determination-of-its-degradation-kinetics-in-biological-fluids
#20
Rohit Bisht, Ilva D Rupenthal, Sreevalsan Sreebhavan, Jagdish K Jaiswal
Connexin43 mimetic peptide (Cx43MP) has been intensively investigated for its therapeutic effect in the management of inflammatory eye conditions, spinal cord injury, wound healing and ischemia-induced brain damage. Here, we report on a validated stability-indicating reversed-phase high performance liquid chromatography (RP-HPLC) method for the quantification of Cx43MP under stress conditions. These included exposure to acid/base, light, oxidation and high temperature. In addition, the degradation kinetics of the peptide were evaluated in bovine vitreous and drug-free human plasma at 37 °C...
December 2017: Journal of Pharmaceutical Analysis
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