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therapeutic hypothermia and stroke

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https://www.readbyqxmd.com/read/28437236/temperature-variation-after-rewarming-from-deep-hypothermic-circulatory-arrest-is-associated-with-survival-and-neurologic-outcome
#1
Alessio Rungatscher, Giovanni Battista Luciani, Daniele Linardi, Elisabetta Milani, Leonardo Gottin, Beat Walpoth, Giuseppe Faggian
Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic circulatory arrest (DHCA) for aortic arch surgery on survival and neurologic outcome are undefined. We hypothesize that temperature variation after aortic arch surgery is associated with survival and neurologic outcome. In the period 2010-2014, a total of 210 consecutive patients undergoing aortic arch surgery with DHCA were included...
March 1, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28366066/neuroprotective-strategies-and-the-underlying-molecular-basis-of-cerebrovascular-stroke
#2
REVIEW
Michael Karsy, Andrea Brock, Jian Guan, Phillip Taussky, M Yashar S Kalani, Min S Park
Stroke is a leading cause of disability in the US. Although there has been significant progress in the area of medical and surgical thrombolytic technologies, neuroprotective agents to prevent secondary cerebral injury and to minimize disability remain limited. Only limited success has been reported in preclinical and clinical trials evaluating a variety of compounds. In this review, the authors discuss the most up-to-date information regarding the underlying molecular biology of stroke as well as strategies that aim to mitigate this complex signaling cascade...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28350280/no-benefits-of-hypothermia-in-patients-treated-with-hemicraniectomy-for-large-ischemic-stroke
#3
Hauke Schneider, Philipp Krüger, Ale Algra, Jeannette Hofmeijer, H Bart van der Worp, Eric Jüttler, Katayoun Vahedi, Gabriele Schackert, Heinz Reichmann, Volker Puetz
Background Space-occupying middle cerebral artery brain infarcts are associated with the development of brain edema, which may lead to cerebral herniation and death despite early hemicraniectomy. Aims To evaluate the benefit of therapeutic hypothermia in patients with space-occupying cerebral infarction treated with hemicraniectomy within 48 h of stroke onset. Methods Patients aged 18-60 years with space-occupying cerebral infarction treated with hemicraniectomy within 48 h and hypothermia (33-34°C) were selected from a single university hospital between 2001 and 2010 (n = 53)...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28217292/oxygen-or-cooling-to-make-a-decision-after-acute-ischemia-stroke
#4
REVIEW
Wen-Cao Liu, Xin-Chun Jin
The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA), which remains the only United States Food and Drug Administration (FDA) approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT)...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28118390/anesthesia-induced-hypothermia-attenuates-early-phase-blood-brain-barrier-disruption-but-not-infarct-volume-following-cerebral-ischemia
#5
Yu-Cheng Liu, Yu-Da Lee, Hwai-Lee Wang, Kate Hsiurong Liao, Kuen-Bao Chen, Kin-Shing Poon, Yu-Ling Pan, Ted Weita Lai
Blood-brain barrier (BBB) disruption is thought to facilitate the development of cerebral infarction after a stroke. In a typical stroke model (such as the one used in this study), the early phase of BBB disruption reaches a peak 6 h post-ischemia and largely recovers after 8-24 h, whereas the late phase of BBB disruption begins 48-58 h post-ischemia. Because cerebral infarct develops within 24 h after the onset of ischemia, and several therapeutic agents have been shown to reduce the infarct volume when administered at 6 h post-ischemia, we hypothesized that attenuating BBB disruption at its peak (6 h post-ischemia) can also decrease the infarct volume measured at 24 h...
2017: PloS One
https://www.readbyqxmd.com/read/28110588/neuroprotective-effects-of-adjunctive-treatments-for-acute-stroke-thrombolysis-a-review-of-clinical-evidence
#6
Hongxing Zhou, Suyun Huang, Gavin Sunnassee, Weiyu Guo, Jian Chen, Yang Guo, Sheng Tan
The narrow therapeutic time window and risk of intracranial hemorrhage largely restrict the clinical application of thrombolysis in acute ischemic stroke. Adjunctive treatments added to rt-PA may be beneficial to improve the capacity of neural cell to withstand ischemia, and to reduce the hemorrhage risk as well. This review aims to evaluate the neuroprotective effects of adjunctive treatments in combination with thrombolytic therapy for acute ischemic stroke. Relevant studies were searched in the PubMed, Web of Science and EMBASE database...
February 7, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27998282/does-therapeutic-hypothermia-during-extracorporeal-cardiopulmonary-resuscitation-preserve-cardiac-function
#7
Harald A Bergan, Per S Halvorsen, Helge Skulstad, Erik Fosse, Jan F Bugge
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (E-CPR) is increasingly used as a rescue method in the management of cardiac arrest and provides the opportunity to rapidly induce therapeutic hypothermia. The survival after a cardiac arrest is related to post-arrest cardiac function, and the application of therapeutic hypothermia post-arrest is hypothesized to improve cardiac outcome. The present animal study compares normothermic and hypothermic E-CPR considering resuscitation success, post-arrest left ventricular function and magnitude of myocardial injury...
December 20, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27933367/antipsychotic-inductors-of-brain-hypothermia-and-torpor-like-states-perspectives-of-application
#8
REVIEW
Yury S Tarahovsky, Irina S Fadeeva, Natalia P Komelina, Maxim O Khrenov, Nadezhda M Zakharova
Hypothermia and hypometabolism (hypometabothermia) normally observed during natural hibernation and torpor, allow animals to protect their body and brain against the damaging effects of adverse environment. A similar state of hypothermia can be achieved under artificial conditions through physical cooling or pharmacological effects directed at suppression of metabolism and the processes of thermoregulation. In these conditions called torpor-like states, the mammalian ability to recover from stroke, heart attack, and traumatic injuries greatly increases...
January 2017: Psychopharmacology
https://www.readbyqxmd.com/read/27906602/meta-analysis-of-pre-clinical-trials-of-therapeutic-hypothermia-for-intracerebral-hemorrhage
#9
Kara R Melmed, Patrick D Lyden
Therapeutic hypothermia (TH) is a potent neuroprotectant for experimental ischemic stroke, but studies of TH for intracerebral hemorrhage (ICH) are emerging. We systematically reviewed the experimental literature to assess TH efficacy for ICH. We found 18 suitable papers; quality scores were moderately good. Compared with normothermia, TH reduced measures of edema (mean effect size (95% CI) -1.6873 (-2.3640, -1.0106), p < 0.0001) or blood-brain barrier leakage (p < 0.0001) and improved behavioral outcomes (p < 0...
December 1, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27896650/neuroprotection-by-chlorpromazine-and-promethazine-in-severe-transient-and-permanent-ischemic-stroke
#10
Xiaokun Geng, Fengwu Li, James Yip, Changya Peng, Omar Elmadhoun, Jiamei Shen, Xunming Ji, Yuchuan Ding
Previous studies have demonstrated depressive or hibernation-like roles of phenothiazine neuroleptics [combined chlorpromazine and promethazine (C + P)] in brain activity. This ischemic stroke study aimed to establish neuroprotection by reducing oxidative stress and improving brain metabolism with post-ischemic C + P administration. Sprague-Dawley rats were subjected to transient (2 or 4 h) middle cerebral artery occlusion (MCAO) followed by 6 or 24 h reperfusion, or permanent (28 h) MCAO without reperfusion...
November 28, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27834742/results-of-the-ictus-2-trial-intravascular-cooling-in-the-treatment-of-stroke-2
#11
Patrick Lyden, Thomas Hemmen, James Grotta, Karen Rapp, Karin Ernstrom, Teresa Rzesiewicz, Stephanie Parker, Mauricio Concha, Syed Hussain, Sachin Agarwal, Brett Meyer, Julie Jurf, Irfan Altafullah, Rema Raman
BACKGROUND AND PURPOSE: Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients. METHODS: Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27663968/transarterial-regional-hypothermia-provides-robust-neuroprotection-in-a-rat-model-of-permanent-middle-cerebral-artery-occlusion-with-transient-collateral-hypoperfusion
#12
Kota Kurisu, Takeo Abumiya, Masaki Ito, Masayuki Gekka, Toshiya Osanai, Hideo Shichinohe, Naoki Nakayama, Ken Kazumata, Kiyohiro Houkin
The robust neuroprotective effects of transarterial regional hypothermia have been demonstrated in the typical transient middle cerebral artery occlusion (tMCAO) model, but have not yet been tested in other ischemic stroke models, even though clinical ischemic conditions are diverse. In order to clarify these effects in a different ischemic stroke model, we employed a rat model of permanent MCAO (pMCAO) with transient collateral hypoperfusion (tCHP), which was achieved by direct MCA ligation through craniotomy and 1-hour bilateral common carotid artery occlusion at the beginning of pMCAO...
September 20, 2016: Brain Research
https://www.readbyqxmd.com/read/27659107/regulation-of-therapeutic-hypothermia-on-inflammatory-cytokines-microglia-polarization-migration-and-functional-recovery-after-ischemic-stroke-in-mice
#13
Jin Hwan Lee, Zheng Z Wei, Wenyuan Cao, Soonmi Won, Xiaohuan Gu, Megan Winter, Thomas A Dix, Ling Wei, Shan Ping Yu
Stroke is a leading threat to human life and health in the US and around the globe, while very few effective treatments are available for stroke patients. Preclinical and clinical studies have shown that therapeutic hypothermia (TH) is a potential treatment for stroke. Using novel neurotensin receptor 1 (NTR1) agonists, we have demonstrated pharmacologically induced hypothermia and protective effects against brain damages after ischemic stroke, hemorrhage stroke, and traumatic brain injury (TBI) in rodent models...
December 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/27585797/the-contribution-of-heart-rate-to-the-oxygen-consumption-of-the-chicken-embryo-during-cold-or-hypoxia-hypometabolism
#14
Satoko Tomita Ide, Ryoji Ide, Jacopo P Mortola
In embryos, cooling and hypoxia cause a decrease in oxygen consumption ( [Formula: see text] ); we asked what was the relative contribution of heart rate (HR) and of the 'not-HR' factor (the product of stroke volume and arterial-venous O2 difference) to the drop in [Formula: see text] . Data of HR (with subcutaneous electrodes) and [Formula: see text] (by an open-flow methodology) were collected simultaneously on chicken embryos close to end-incubation. Over the last four days of incubation (E16-E20) differences in HR contributed about 30% of the differences in resting [Formula: see text] among embryos...
January 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/27544687/hypothermia-inhibits-the-propagation-of-acute-ischemic-injury-by-inhibiting-hmgb1
#15
Jung Ho Lee, Eun Jang Yoon, Jeho Seo, Adriana Kavoussi, Yong Eun Chung, Sung Phil Chung, Incheol Park, Chul Hoon Kim, Je Sung You
Acute ischemic stroke causes significant chronic disability worldwide. We designed this study to clarify the mechanism by which hypothermia helps alleviate acute ischemic stroke. In a middle cerebral artery occlusion model (4 h ischemia without reperfusion), hypothermia effectively reduces mean infarct volume. Hypothermia also prevents neurons in the infarct area from releasing high mobility group box 1 (HMGB1), the most well-studied damage-associated molecular pattern protein. By preventing its release, hypothermia also prevents the typical middle cerebral artery occlusion-induced increase in serum HMGB1...
2016: Molecular Brain
https://www.readbyqxmd.com/read/27514013/long-term-survival-and-regeneration-of-neuronal-and-vasculature-cells-inside-the-core-region-after-ischemic-stroke-in-adult-mice
#16
Michael Qize Jiang, Ying-Ying Zhao, Wenyuan Cao, Zheng Zachory Wei, Xiaohuan Gu, Ling Wei, Shan Ping Yu
Focal cerebral ischemia results in an ischemic core surrounded by the peri-infarct region (penumbra). Most research attention has been focused on penumbra while the pattern of cell fates inside the ischemic core is poorly defined. In the present investigation, we tested the hypothesis that, inside the ischemic core, some neuronal and vascular cells could survive the initial ischemic insult while regenerative niches might exist many days after stroke in the adult brain. Adult mice were subjected to focal cerebral ischemia induced by permanent occlusion of distal branches of the middle cerebral artery (MCA) plus transient ligations of bilateral common carotid artery (CCA)...
August 11, 2016: Brain Pathology
https://www.readbyqxmd.com/read/27488978/extended-use-of-hypothermia-in-elderly-patients-with-malignant-cerebral-edema-as-an-alternative-to-hemicraniectomy
#17
Han-Yeong Jeong, Jun-Young Chang, Kyu Sun Yum, Jeong-Ho Hong, Jin-Heon Jeong, Min-Ju Yeo, Hee-Joon Bae, Moon-Ku Han, Kiwon Lee
BACKGROUND AND PURPOSE: The use of decompressive hemicraniectomy (DHC) for the treatment of malignant cerebral edema can decrease mortality rates. However, this benefit is not sufficient to justify its use in elderly patients. We investigated the effects of therapeutic hypothermia (TH) on safety, feasibility, and functional outcomes in elderly patients with malignant middle cerebral artery (MCA) infarcts. METHODS: Elderly patients 60 years of age and older with infarcts affecting more than two-thirds of the MCA territory were included...
September 2016: Journal of Stroke
https://www.readbyqxmd.com/read/27333659/hibernation-hypothermia-and-a-possible-therapeutic-shifted-homeostasis-induced-by-central-activation-of-a1-adenosine-receptor-a1ar
#18
REVIEW
Domenico Tupone, Justin S Cetas, Shaun F Morrison
The positive outcome that hypothermia contributes to brain and cardiac protection following ischemia has stimulated research in the development of pharmacological approaches to induce a hypothermic/hypometabolic state. Pharmacological manipulation of central autonomic thermoregulatory circuits could represent a potential target for the induction of a hypothermic state. Here we present a brief description of the CNS thermoregulatory centers and how the manipulation of these circuits can be useful in the treatment of pathological conditions such as stroke or brain hemorrhage...
April 2016: Nihon Shinkei Seishin Yakurigaku Zasshi, Japanese Journal of Psychopharmacology
https://www.readbyqxmd.com/read/27327871/temperature-control-in-rodent-neuroprotection-studies-methods-and-challenges
#19
Ana C Klahr, Colby A Nadeau, Frederick Colbourne
Extensive animal research facilitated the clinical translation of therapeutic hypothermia for cardiac arrest in adults and hypoxic-ischemic injury in infants. Similarly, clinical interest in hypothermia for other brain injuries, such as stroke, has been greatly supported by positive findings in preclinical work. The reliability, validity, and utility of animal models, among many research practices (blinding, randomization, etc.), are key to successful clinical translation. Here, we review methods used to induce and maintain hypothermia in animal models...
March 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27313963/therapeutic-hypothermia-and-ischemic-stroke-a-literature-review
#20
Rizwan A Tahir, Aqueel H Pabaney
BACKGROUND: Ischemic stroke is the fifth leading cause of death in the US. Clinical techniques aimed at helping to reduce the morbidity associated with stroke have been studied extensively, including therapeutic hypothermia. In this study, the authors review the literature regarding the role of therapeutic hypothermia in ischemic stroke to appreciate the evolution of hypothermia technology over several decades and to critically analyze several early clinical studies to validate its use in ischemic stroke...
2016: Surgical Neurology International
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