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Hypothermia after cardiac arrest

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https://www.readbyqxmd.com/read/28521971/comparison-of-early-sequential-hypothermia-and-delayed-hypothermia-on-neurological-function-after-resuscitation-in-a-swine-model
#1
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
BACKGROUND: We utilized a porcine cardiac arrest model to compare early sequential hypothermia (ESH) with delayed hypothermia (DH) and no hypothermia (NH) to investigate the different effects on cerebral function after resuscitation. METHODS: After return of spontaneous circulation (ROSC), resuscitated 24 pigs divided into three groups. The ESH group implemented early sequential hypothermia immediately, and the DH group implemented delayed hypothermia at 1 h after ROSC...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28513117/routine-laboratory-indices-as-predictor-of-neurological-recovery-in-post-resuscitation-syndrome-patients-treated-with-therapeutic-hypothermia
#2
Sa'ar Minha, Tali Taraboulos, Gabby Elbaz-Greener, Eran Kalmanovich, Zvi Vered, Alex Blatt
BACKGROUND: Hypothermia is associated with improved outcome in selected survivors of cardiac arrest but no single metric enables proper prediction of neurological outcome. OBJECTIVES: To explored the association between routine laboratory indices of patients treated by hypothermia for cardiac arrest and their neurological outcome. METHODS: We retrospectively collected data from survivors of cardiac arrest treated with hypothermia for 24 hours and grouped them according to their neurological outcome to either "poor" or "favorable"...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28508339/induction-of-hibernation-like-hypothermia-by-central-activation-of-the-a1-adenosine-receptor-in-a-non-hibernator-the-rat
#3
Hiroki Shimaoka, Takayuki Kawaguchi, Kahori Morikawa, Yuuki Sano, Kiyotada Naitou, Hiroyuki Nakamori, Takahiko Shiina, Yasutake Shimizu
Central adenosine A1-receptor (A1AR)-mediated signals play a role in the induction of hibernation. We determined whether activation of the central A1AR enables rats to maintain normal sinus rhythm even after their body temperature has decreased to less than 20 °C. Intracerebroventricular injection of an adenosine A1 agonist, N6-cyclohexyladenosine (CHA), followed by cooling decreased the body temperature of rats to less than 20 °C. Normal sinus rhythm was fundamentally maintained during the extreme hypothermia...
May 15, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28506940/cool-ami-eu-pilot-trial-a-multicentre-prospective-randomised-controlled-trial-to-assess-cooling-as-an-adjunctive-therapy-to-percutaneous-intervention-in-patients-with-acute-myocardial-infarction
#4
Marko Noc, David Erlinge, Aleksandar N Neskovic, Srdjan Kafedzic, Béla Merkely, Endre Zima, Misa Fister, Milovan Petrović, Milenko Čanković, Gábor Veress, Peep Laanmets, Teele Pern, Vladan Vukcevic, Vladimir Dedovic, Beata Średniawa, Andrzej Świątkowski, Thomas R Keeble, John R Davies, Alexandra-Maria Warenits, Göran Olivecrona, Jan Zbigniew Peruga, Michal Ciszewski, Ivan Horvath, Istvan Edes, Gergely Gyorgy Nagy, Daniel Aradi, Michael Holzer
AIMS: We aimed to investigate the rapid induction of therapeutic hypothermia using the ZOLL Proteus Intravascular Temperature Management System in patients with anterior ST-elevation myocardial infarction (STEMI) without cardiac arrest. METHODS AND RESULTS: A total of 50 patients were randomised; 22 patients (88%; 95% confidence interval [CI]: 69-97%) in the hypothermia group and 23 patients (92%; 95% CI: 74-99) in the control group completed cardiac magnetic resonance imaging at four to six days and 30-day follow-up...
May 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28495952/deep-and-profound-hypothermia-in-haemorrhagic-shock-friend-or-foe-a-systematic-review
#5
REVIEW
Samuel E Moffatt, S J B Mitchell, J L Walke
INTRODUCTION: Survival in exsanguinating cardiac arrest patients is poor, as is neurological outcome in survivors. Hypothermia has traditionally been seen as harmful to trauma patients and associated with increased mortality; however, there has been speculation that cooling to very low temperatures (≤20°C) could be used to treat haemorrhagic trauma patients by the induction of a suspended animation period through extreme cooling, which improves survival and preserves neurological function...
May 11, 2017: Journal of the Royal Army Medical Corps
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
#6
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 10, 2017: Neurology
https://www.readbyqxmd.com/read/28490379/a-novel-scoring-system-for-predicting-the-neurologic-prognosis-prior-to-the-initiation-of-induced-hypothermia-in-cases-of-post-cardiac-arrest-syndrome-the-cast-score
#7
Mitsuaki Nishikimi, Naoyuki Matsuda, Kota Matsui, Kunihiko Takahashi, Tadashi Ejima, Keibun Liu, Takayuki Ogura, Michiko Higashi, Hitoshi Umino, Go Makishi, Atsushi Numaguchi, Satoru Matsushima, Hideki Tokuyama, Mitsunobu Nakamura, Shigeyuki Matsui
BACKGROUND: The aim of this study was to develop a scoring system for identifying the post-cardiac arrest syndrome (PCAS) patients with a good potential for recovery prior to the initiation of induced therapeutic hypothermia. METHODS: A multi-center, retrospective, observational study was performed. Data of a total of 151 consecutive adults who underwent induced hypothermia after cardiac arrest (77 learning cases from two hospitals and 74 validation cases from two other hospitals) were analyzed...
May 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28481829/a-population-pharmacokinetic-analysis-to-study-the-effect-of-therapeutic-hypothermia-on-vancomycin-disposition-in-children-resuscitated-from-cardiac-arrest
#8
Nicole R Zane, Michael D Reedy, Marc R Gastonguay, Adam S Himebauch, Evan Z Ramsey, Alexis A Topjian, Athena F Zuppa
OBJECTIVES: Limited data exist on the effects of therapeutic hypothermia on renal function and pharmacokinetics in pediatric patients after cardiac arrest. The objective was to describe the differences in vancomycin disposition in pediatric patients following cardiac arrest treated with either therapeutic hypothermia or normothermia using population pharmacokinetic modeling. DESIGN: Single-center, retrospective cohort study. SETTING: A tertiary care hospital pediatric and cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28466294/-cardiac-support-and-replacement-systems
#9
REVIEW
T Graf, H Thiele
In recent years, the widespread use of partial mechanical cardiac support and even temporary complete replacement of cardiac function has been established in many intensive care units in the treatment of refractory cardiogenic shock. There is a difference between partial left-ventricular assist devices (LVAD) and the possibility of complete heart (and lung) replacement by extra corporeal life support (ECLS). Despite the use of mechanical support devices, the mortality of cardiogenic shock remains high. The consideration of using percutaneous LVAD and ECLS in cardiogenic shock should be considered in refractory cardiogenic shock patients in addition to support by catecholamines and after early revascularization in acute coronary syndromes...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28465012/mild-induced-hypothermia-and-survival-after-out-of-hospital-cardiac-arrest-in-a-swedish-urban-area
#10
Louise Martinell, Johan Herlitz, Thomas Karlsson, Niklas Nielsen, Christian Rylander
BACKGROUND: Mild induced hypothermia (MIH) was introduced for post cardiac arrest care in Sweden in 2003, based on two clinical trials. This retrospective study evaluated its association with 30-day survival after out-of-hospital cardiac arrest (OHCA) in a Swedish community from 2003 to 2015. METHODS: Out of 3680 patients with OHCA, 1100 were hospitalized after return of spontaneous circulation and 871 patients who remained unconscious were included in the analysis...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28460021/hypothermia-and-cerebral-protection-strategies-in-aortic-arch-surgery-a-comparative-effectiveness-analysis-from-the-sts-adult-cardiac-surgery-database
#11
Brian R Englum, Xia He, Brian C Gulack, Asvin M Ganapathi, Joseph P Mathew, J Matthew Brennan, T Brett Reece, W Brent Keeling, Bradley G Leshnower, Edward P Chen, Jeffrey P Jacobs, Vinod H Thourani, G Chad Hughes
OBJECTIVES: Hypothermic circulatory arrest is essential to aortic arch surgery, although consensus regarding optimal cerebral protection strategy remains lacking. We evaluated the current use and comparative effectiveness of hypothermia/cerebral perfusion (CP) strategies in aortic arch surgery. METHODS: Using the Society of Thoracic Surgeons Database, cases of aortic arch surgery with hypothermic circulatory arrest from 2011 to 2014 were categorized by hypothermia strategy-deep/profound (D/P; ≤20°C), low-moderate (L-M; 20...
April 29, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28450915/emulsified-isoflurane-combined-with-therapeutic-hypothermia-improves-survival-and-neurological-outcomes-in-a-rat-model-of-cardiac-arrest
#12
Meng-Jun Wu, Ya-Jie Zhang, Hai Yu, Bin Liu
Emulsified isoflurane (EIso), when introduced following cardiopulmonary resuscitation (CPR), significantly improves survival and neurological outcomes in a rat model of cardiac arrest (CA). The present study aimed to examine whether EIso combined with therapeutic hypothermia (TH) confers an additive neuroprotective effect. Adult male Sprague-Dawley rats that were subjected to return of spontaneous circulation (ROSC) after a 6-min asphyxia-induced CA were randomized to five groups: Sham group, control group under normothermic conditions, EIso group (4 ml/kg for 30 min under normothermic conditions), TH group (33°C for 2 h), and EIso plus TH group...
March 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28445675/hypothermia-after-in-hospital-cardiac-arrest-in-children
#13
LETTER
Frank W Moler, Faye S Silverstein, J Michael Dean
No abstract text is available yet for this article.
April 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445674/hypothermia-after-in-hospital-cardiac-arrest-in-children
#14
LETTER
Norbert F Banhidy, David Zhang
No abstract text is available yet for this article.
April 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#15
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28407722/induced-hypothermia-is-associated-with-reduced-circulating-subunits-of-mitochondrial-dna-in-cardiac-arrest-patients
#16
Hamid Aslami, Charlotte J P Beurskens, Anita M Tuip, Janneke Horn, Nicole P Juffermans
Induced hypothermia may protect from ischemia reperfusion injury. The mechanism of protection is not fully understood and may include an effect on mitochondria. Here we describe the effect of hypothermia on circulating mitochondrial (mt) DNA in a substudy of a multicenter randomized trial (the Target Temperature Management trial). Circulating levels of mtDNA were elevated in patients with cardiac arrest at all-time points compared to healthy controls. After 24 h of temperature management, patients kept at 33 °C had significantly lower levels of COX3, NADH1 and NADH2 compared to baseline, in contrast to those kept at 36 °C...
April 13, 2017: Mitochondrial DNA. Part A. DNA Mapping, Sequencing, and Analysis
https://www.readbyqxmd.com/read/28407232/observed-survival-benefit-of-therapeutic-hypothermia-re-analyzing-the-circ-trial
#17
Alexander Nürnberger, Harald Herkner, Fritz Sterz, Jan-Aage Olsen, Michael Lozano, Pierre M van Grunsven, Brooke E Lerner, David Persse, Reinhard Malzer, Marc A Brouwer, Mark Westfall, Chris M Souders, David T Travis, Ulrich R Herken, Lars Wik
BACKGROUND: Mild therapeutic hypothermia is argued being beneficial for outcome after cardiac arrest. MATERIALS AND METHODS: Retrospective analysis of Circulation Improving Resuscitation Care trial data to assess if therapeutic cooling to 33 ±1°C core temperature had an association with survival. Of 4,231 adult out-of-hospital cardiac arrests of presumed cardiac origin initially enrolled, eligibility criteria for therapeutic hypothermia were met by 1,812. Logistic regression was undertaken in a stepwise fashion to account for the impact on outcome of each significant difference and for the variable of interest between the groups...
April 13, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28405859/effects-of-mild-hypothermia-on-cerebral-large-and-small-microvessels-blood-flow-in-a-porcine-model-of-cardiac-arrest
#18
Junyuan Wu, Wei Yuan, Jiebin Li, Yongzhen Zhao, Jie Li, Zhenhua Li, Chunsheng Li
BACKGROUND: The effect of mild hypothermia (MH) on microcirculation after resuscitation from cardiac arrest is controversial. The aim of this study was to determine whether MH improves or aggravates the disturbance of cerebral microcirculation. METHODS: Twenty domestic male pigs were randomized into the MH group (n = 8), non-hypothermia (NH) group (n = 8) or sham operation group (n = 4). In the MH group, the animals were initiated rapid intravascular cooling at 1 h after return of spontaneous circulation (ROSC) from 8 min ventricular fibrillation, and the core temperature was reduced to 33 °C for 12 h and then rewarmed to 37 °C...
April 12, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28391258/dexmedetomidine-combined-with-therapeutic-hypothermia-is-associated-with-cardiovascular-instability-and-neurotoxicity-in-a-piglet-model-of-perinatal-asphyxia
#19
Mojgan Ezzati, Go Kawano, Eridan Rocha-Ferreira, Daniel Alonso-Alconada, Jane K Hassell, Kevin D Broad, Igor Fierens, Bobbi Fleiss, Alan Bainbridge, David L Price, Pardis Kaynezhad, Brian Anderson, Mariya Hristova, Ilias Tachtsidis, Xavier Golay, Pierre Gressens, Robert D Sanders, Nicola J Robertson
The selective α2-adrenoreceptor agonist dexmedetomidine has shown neuroprotective, analgesic, anti-inflammatory, and sympatholytic properties that may be beneficial in neonatal encephalopathy (NE). As therapeutic hypothermia is only partially effective, adjunct therapies are needed to optimize outcomes. The aim was to assess whether hypothermia + dexmedetomidine treatment augments neuroprotection compared to routine treatment (hypothermia + fentanyl sedation) in a piglet model of NE using magnetic resonance spectroscopy (MRS) biomarkers, which predict outcomes in babies with NE, and immunohistochemistry...
April 8, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28389857/predictors-of-good-neurologic-outcome-after-resuscitation-beyond-30%C3%A2-min-in-out-of-hospital-cardiac-arrest-patients-undergoing-therapeutic-hypothermia
#20
Shin Ahn, Byung Kook Lee, Chun Song Youn, Youn-Jung Kim, Chang Hwan Sohn, Dong-Woo Seo, Won Young Kim
Neurologically intact survival after cardiac arrest is possible even after prolonged resuscitation efforts. However, the factors associated with good neurologic outcome in these patients remain unknown. This study identifies predictors associated with good neurologic outcome after resuscitation beyond 30 min in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM). This multicenter, registry-based, retrospective cohort study conducted in 24 hospitals across South Korea between 2007 and 2012 includes adult (≥18 years) non-traumatic OHCA patients with prolonged (>30 min) downtime who underwent TTM treatment...
April 7, 2017: Internal and Emergency Medicine
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