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https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#1
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
October 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28873073/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients-erratum
#2
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28698133/randomized-controlled-trial-of-internal-and-external-targeted-temperature-management-methods-in-post-cardiac-arrest-patients
#3
Xinqi Look, Huihua Li, Mingwei Ng, Eric Tien Siang Lim, Sohil Pothiawala, Kenneth Boon Kiat Tan, Duu Wen Sewa, Nur Shahidah, Pin Pin Pek, Marcus Eng Hock Ong
BACKGROUND: Targeted temperature management post-cardiac arrest is currently implemented using various methods, broadly categorized as internal and external. This study aimed to evaluate survival-to-hospital discharge and neurological outcomes (Glasgow-Pittsburgh Score) of post-cardiac arrest patients undergoing internal cooling verses external cooling. METHODOLOGY: A randomized controlled trial of post-resuscitation cardiac arrest patients was conducted from October 2008-September 2014...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28644823/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients
#4
K Kim, Kimberly L Pargeon, Amy S Labar, Oren Friedman, Padmaja N Kandula, Douglas R Labar
PURPOSE: Continuous video EEG is a tool to assess brain function in injuries, including cardiac arrest (CA). In post-CA therapeutic hypothermia (TH) studies, some EEG features are linked to poor prognosis, but the evolvement of EEG characteristics during two temperature phases and its significance is unclear. We systematically analyzed EEG characteristics in cooled and rewarmed phases of post-CA therapeutic hypothermia patients and investigated their correlation to patient outcome. METHODS: This is a retrospective study of EEG analyses, from a single academic center, of 20 patients who underwent CA and therapeutic hypothermia...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28492973/fast-therapeutic-hypothermia-prevents-post-cardiac-arrest-syndrome-through-cyclophilin-d-mediated-mitochondrial-permeability-transition-inhibition
#5
Vincent Jahandiez, Martin Cour, Thomas Bochaton, Maryline Abrial, Joseph Loufouat, Abdallah Gharib, Annie Varennes, Michel Ovize, Laurent Argaud
The opening of the mitochondrial permeability transition pore (PTP), which is regulated by the matrix protein cyclophilin D (CypD), plays a key role in the pathophysiology of post-cardiac arrest (CA) syndrome. We hypothesized that therapeutic hypothermia could prevent post-CA syndrome through a CypD-mediated PTP inhibition in both heart and brain. In addition, we investigated whether specific pharmacological PTP inhibition would confer additive protection to cooling. Adult male New Zealand White rabbits underwent 15 min of CA followed by 120 min of reperfusion...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28437237/proteomics-in-hypothermia-as-adjunctive-therapy-in-patients-with-st-segment-elevation-myocardial-infarction-a-chill-mi-substudy
#6
Moman A Mohammad, Marco Noc, Irene Lang, Michael Holzer, Peter Clemmensen, Ulf Jensen, Bernhard Metzler, David Erlinge
Cardiovascular and inflammatory biomarkers in therapeutic hypothermia have been studied in cardiac arrest, but data on patients with ST-segment elevation myocardial infarction (STEMI) treated with therapeutic hypothermia are currently unavailable. A multiplex proximity extension assay allowed us to measure 157 cardiovascular disease (CVD) and inflammatory disease-related biomarkers in patients from the international, multicenter, and randomized trial; CHILL-myocardial infarction (MI) and to explore the associations of cardiovascular and inflammatory biomarkers...
March 2, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28352966/cold-blooded-evaluating-brain-temperature-by-mri-during-surface-cooling-of-human-subjects
#7
Eric J Curran, Daniel L Wolfson, Richard Watts, Kalev Freeman
BACKGROUND: Targeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28237918/optimal-control-of-inspired-perfluorocarbon-temperature-for-ultrafast-hypothermia-induction-by-total-liquid-ventilation-in-adult-patient-model
#8
Mathieu Nadeau, Michael Sage, Matthias Kohlhauer, Julien Mousseau, Jonathan Vandamme, Etienne Fortin-Pellerin, Jean-Paul Praud, Renaud Tissier, Herve Walti, Philippe Micheau
OBJECTIVE: Recent preclinical studies have shown that therapeutic hypothermia induced in less than 30 min by total liquid ventilation (TLV) strongly improves the survival rate after cardiac arrest. When the lung is ventilated with a breathable perfluorocarbon liquid, the inspired perfluorocarbon allows to control efficiently the cooling process of the organs. While TLV can rapidly cool animals, the cooling speed in humans remains unknown. The objective is to predict the efficiency and safety of ultrafast cooling by TLV in adult humans...
February 20, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28004331/delayed-deterioration-of-eeg-background-rhythm-post-cardiac-arrest
#9
Tadeu A Fantaneanu, Rani Sarkis, Kathleen Avery, Benjamin M Scirica, Shelley Hurwitz, Galen V Henderson, Jong Woo Lee
BACKGROUND: Electroencephalogram (EEG) background continuity is associated with a favorable prognosis in cardiac arrest patients post-therapeutic hypothermia. However, the continuous EEG in a subset of patients will undergo 'delayed EEG deterioration'; they will invariably have poor outcome. The aim of this study was to characterize this phenomenon. METHODS: We studied a prospectively collected cohort of consecutive cardiac arrest patients who underwent therapeutic hypothermia between July 2012 and May 2015...
June 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27913267/a-comparison-between-intravascular-and-traditional-cooling-for-inducing-and-maintaining-temperature-control-in-patients-following-cardiac-arrest
#10
Jérémy Rosman, Maxime Hentzien, Moustapha Dramé, Vincent Roussel, Bernard Just, Damien Jolly, Philippe Mateu
Therapeutic temperature control has been widely used during the last decade to improve clinical outcomes. We conducted this retrospective observational study to compare traditional cooling with endovascular cooling in post-cardiac arrest comatose survivors and to compare results with current guidelines. PATIENTS AND METHODS: All patients admitted to our ICU for cardiac arrest and for whom temperature control was performed were included. Traditional cooling included cold infusions, ice packs and cooling blankets...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#11
REVIEW
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27782794/clinical-effect-of-rebound-hyperthermia-after-cooling-postcardiac-arrest-a-retrospective-cohort-study
#12
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27622966/effect-of-hypothermia-and-targeted-temperature-management-on-drug-disposition-and-response-following-cardiac-arrest-a-comprehensive-review-of-preclinical-and-clinical-investigations
#13
REVIEW
Kacey B Anderson, Samuel M Poloyac, Patrick M Kochanek, Philip E Empey
Targeted temperature management (TTM) has been shown to reduce mortality and improve neurological outcomes in out-of-hospital cardiac arrest (CA) patients and in neonates with hypoxic-ischemic encephalopathy (HIE). TTM has also been associated with adverse drug events in the critically ill patient due to its effect on drug pharmacokinetics (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA. MEDLINE/PubMed databases were searched for publications, which include the MeSH terms hypothermia, drug metabolism, drug transport, P450, critical care, cardiac arrest, hypoxic-ischemic encephalopathy, pharmacokinetics, and pharmacodynamics between July 2006 and October 2015...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27521473/combined-intra-and-post-cardiac-arrest-hypothermic-targeted-temperature-management-in-a-rat-model-of-asphyxial-cardiac-arrest-improves-survival-and-neurologic-outcome-compared-to-either-strategy-alone
#14
Taeyun Kim, Michael G Paine, He Meng, Ren Xiaodan, Jacob Cohen, Tulasi Jinka, Huiyong Zheng, James A Cranford, Robert W Neumar
AIM: Post-cardiac arrest hypothermic-targeted temperature management (HTTM) improves outcomes in preclinical cardiac arrest studies. However, inadequate understanding of the mechanisms and therapeutic windows remains a barrier to optimization. We tested the hypothesis that combined intra- and post-cardiac arrest HTTM provides a synergistic outcome benefit compared to either strategy alone. METHODS: Rats subjected to 8-min asphyxial cardiac arrest were block randomized to 4 treatment groups (n=12/group): NTTM) normothermic-targeted temperature management; 1-24 HTTM) HTTM initiated 1h post-ROSC and maintained for 24h; Intra-1 HTTM) HTTM initiated at CPR onset and maintained for 1h; and Intra-24 HTTM) HTTM initiated at CPR onset and maintained for 24h...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27366542/post-operative-malignant-hyperthermia-in-a-child-after-colon-interposition
#15
Sevtap Hekimoğlu Şahin, Mustafa İnan, Burhan Aksu, Naci Öner, Alkin Çolak, Ahmet Güzel
Malignant hyperthermia (MH) is a rare and potentially life threatening fatal complication of anaesthesia. We present a 2-year-old boy with late onset MH after colon interposition to replace the oesophagus under sevoflurane anaesthesia. The patient was treated with intravenous dantrolene sodium as well as cooling and controlled ventilation. Despite treatment, the patient developed cardiopulmonary arrest at 21 hours after the operation and died. It should be kept in mind that post-operative MH may develop during these types of operations with ischaemia-reperfusion injuries...
December 2015: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27242031/effect-of-ultra-fast-mild-hypothermia-using-total-liquid-ventilation-on-hemodynamics-and-respiratory-mechanics
#16
Michaël Sage, Mathieu Nadeau, Matthias Kohlhauer, Jean-Paul Praud, Renaud Tissier, Raymond Robert, Hervé Walti, Philippe Micheau
Ultra-fast cooling for mild therapeutic hypothermia (MTH) has several potential applications, including prevention of post-cardiac arrest syndrome. Ultra-fast MTH by total liquid ventilation (TLV) entails the sudden filling of the lungs with a cold perfluorocarbon liquid and its subsequent use to perform TLV. The present physiological study was aimed at assessing whether pulmonary and systemic hemodynamics as well as lung mechanics are significantly altered during this procedure. Pulmonary and systemic arterial pressures, cardiac output as well as airway resistance and respiratory system compliance were measured during ultra-fast MTH by TLV followed by rewarming and normothermia in six healthy juvenile lambs...
August 2016: Cryobiology
https://www.readbyqxmd.com/read/27190339/hypothermia-and-kidney-a-focus-on-ischaemia-reperfusion-injury
#17
Silvia De Rosa, Massimo Antonelli, Claudio Ronco
Cellular damage after reperfusion of ischaemic tissue is defined as ischaemia-reperfusion injury (IRI). Hypothermia is able to decrease oxygen consumption, preventing a rapid loss of mitochondrial activity. However, even though cooling can help to decrease the deleterious effects of ischaemia, the consequences are not exclusively beneficial, such that hypothermic storage is a compromise between benefits and harm. The present review details the relationship between renal IRI and hypothermia, describing the pathophysiology of IRI and hypothermic protection through experimental evidence...
April 6, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27036662/influence-of-the-temperature-on-the-moment-of-awakening-in-patients-treated-with-therapeutic-hypothermia-after-cardiac-arrest
#18
Ines Ponz, Esteban Lopez-de-Sa, Eduardo Armada, Juan Caro, Zorba Blazquez, Sandra Rosillo, Oscar Gonzalez, Juan Ramon Rey, Maria Del Carmen Monedero, Jose Luis Lopez-Sendon
INTRODUCTION: Target temperature management (TTM) has shown to reduce brain damage after an out-of-hospital cardiac arrest (CA), but the time to neurological recovery is not defined yet. We sought to determine the time these patients need to regain consciousness, as well as factors associated with a late post-arrest awakening. METHODS: We performed a retrospective analysis of patients cooled to 32-34°C during 24h after CA, who regained neurological responsiveness after rewarming...
June 2016: Resuscitation
https://www.readbyqxmd.com/read/26906333/the-introduction-of-an-esophageal-heat-transfer-device-into-a-therapeutic-hypothermia-protocol-a-prospective-evaluation
#19
Andrej Markota, Jure Fluher, Barbara Kit, Petra Balažič, Andreja Sinkovič
BACKGROUND: Temperature management is a recommended part of post-resuscitation care of comatose survivors of cardiac arrest. A number of methods exist for temperature management, all of which have limitations. We aimed to evaluate the performance and ease of use of a new esophageal heat transfer device (EHTD; Advanced Cooling Therapy, Chicago, IL, USA) for temperature management of adult survivors of cardiac arrest. METHODS: We performed a prospective study from March to June 2015...
April 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26820272/how-cool-it-is-targeted-temperature-management-for-brain-protection-post-cardiac-arrest
#20
REVIEW
Alejandro A Rabinstein
Neurological recovery often determines outcome in patients resuscitated after cardiac arrest. Temperature control as a neuroprotective strategy has become standard of care. The first randomized trials showing improved neurological outcomes in patients treated with hypothermia with a target temperature of 33°C over a decade ago led to the inclusion of this intervention in practice guidelines and the broad adoption of hypothermia protocols across the world. More recently, large randomized trials showed no difference from targeting a temperature of 33 or 36°C and no benefit from pre-hospital induction of hypothermia...
February 2016: Seminars in Respiratory and Critical Care Medicine
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