keyword
https://read.qxmd.com/read/38510376/cerebral-perfusion-and-metabolism-with-mild-hypercapnia-vs-normocapnia-in-a-porcine-post-cardiac-arrest-model-with-and-without-targeted-temperature-management
#1
JOURNAL ARTICLE
Hilde Karlsen, Runar J Strand-Amundsen, Christiane Skåre, Morten Eriksen, Vidar M Skulberg, Kjetil Sunde, Tor Inge Tønnessen, Theresa M Olasveengen
AIM: To determine whether targeting mild hypercapnia (PaCO2 7 kPa) would yield improved cerebral blood flow and metabolism compared to normocapnia (PaCO2 5 kPa) with and without targeted temperature management to 33 °C (TTM33) in a porcine post-cardiac arrest model. METHODS: 39 pigs were resuscitated after 10 minutes of cardiac arrest using cardiopulmonary bypass and randomised to TTM33 or no-TTM, and hypercapnia or normocapnia. TTM33 was managed with intravasal cooling...
June 2024: Resuscitation plus
https://read.qxmd.com/read/38417773/the-design-of-the-princess-2-trial-a-randomized-trial-to-study-the-impact-of-ultrafast-hypothermia-on-complete-neurologic-recovery-after-out-of-hospital-cardiac-arrest-with-initial-shockable-rhythm
#2
JOURNAL ARTICLE
Emelie Dillenbeck, Jacob Hollenberg, Michael Holzer, Hans-Jörg Busch, Graham Nichol, Peter Radsel, Jan Belohlavec, Ervigio Corral Torres, Esteban López-de-Sa, Fernando Rosell, Giuseppe Ristagno, Sune Forsberg, Filippo Annoni, Leif Svensson, Martin Jonsson, Denise Bäckström, Mikael Gellerfors, Akil Awad, Fabio S Taccone, Per Nordberg
BACKGROUND: Delayed hypothermia, initiated after hospital arrival, several hours after cardiac arrest with 8-10 hours to reach the target temperature, is likely to have limited impact on overall survival. However, the effect of ultrafast hypothermia, i.e., delivered intra-arrest or immediately after return of spontaneous circulation (ROSC), on functional neurologic outcome after out-of-hospital cardiac arrest (OHCA) is unclear. In two prior trials, prehospital trans-nasal evaporative intra-arrest cooling was safe, feasible and reduced time to target temperature compared to delayed cooling...
February 28, 2024: American Heart Journal
https://read.qxmd.com/read/38286123/the-modulatory-role-of-hypothermia-in-post-stroke-brain-inflammation-mechanisms-and-clinical-implications
#3
REVIEW
Wei Xu, Xiaokun Geng, Aminah I Fayyaz, Yuchuan Ding
BACKGROUND: Acute ischemic stroke remains a major contributor to mortality and disability worldwide. The use of hypothermia has emerged as a promising neuroprotective strategy, with proven effectiveness in cardiac arrest and neonatal hypoxic-ischemic injury. SUMMARY: This review explores the therapeutic potential of hypothermia in ischemic stroke by examining its impact on post-stroke inflammatory responses. We synthesized evidence from basic and clinical studies to illustrate the inhibitory effects of hypothermia on post-stroke brain inflammation...
January 29, 2024: Cerebrovascular Diseases
https://read.qxmd.com/read/38176890/postarrest-care-bundle-improves-quality-of-care-and-clinical-outcomes-in-the-normothermia-era
#4
JOURNAL ARTICLE
Andrew J Caddell, Dave Nagpal, Ahmed F Hegazy
PURPOSE: Temperature targets in patients with cardiac arrest and return of spontaneous circulation (ROSC) have changed. Changes to higher temperature targets have been associated with higher breakthrough fevers and mortality. A post-ROSC normothermia bundle was developed to improve compliance with temperature targets. METHODS: In August 2021, "ad hoc" normothermia at the discretion of the attending intensivist was initiated. In December 2021, a post-ROSC normothermia protocol was implemented, incorporating a rigorous, stepwise approach to fever prevention (temperature ≥ 37...
January 4, 2024: Journal of Intensive Care Medicine
https://read.qxmd.com/read/37680442/effectiveness-of-induced-hypothermia-on-the-prognosis-of-post-cardiac-arrest-patients-a-scoping-literature-review
#5
REVIEW
Ralph Kingsford Rohit, Charu Tibrewal, Naisargi Shrikant Modi, Parth S Bajoria, Prathma Anandbhai Dave, Siddharth Kamal Gandhi, Priyansh Patel
Cardiac arrest (CA) is one of the leading causes of death worldwide. Therapeutic hypothermia (TH) is hypothesized to be a reliable practice for better prognosis in post-cardiac arrest (PCA) patients. Medical subject headings (MeSH) terminology was used to search PubMed Central, Medline, and PubMed databases for articles on the use of hypothermia in PCA patients. We selected various clinical trials, meta-analyses and review articles with complete texts in the English language. PCA syndrome occurs after a CA where the body experiences a state of global ischemia and multi-system dysfunction due to the release of reactive oxygen species (ROS) and inflammatory mediators...
August 2023: Curēus
https://read.qxmd.com/read/37219898/a-systematic-literature-review-to-assess-fever-management-and-the-quality-of-targeted-temperature-management-in-critically-ill-patients
#6
JOURNAL ARTICLE
Benjamin Miao, Jeffrey R Skaar, Matthew O'Hara, Andrew Post, Tim Kelly, Benjamin S Abella
Targeted temperature management (TTM) has been proposed to reduce mortality and improve neurological outcomes in postcardiac arrest and other critically ill patients. TTM implementation may vary considerably among hospitals, and "high-quality TTM" definitions are inconsistent. This systematic literature review in relevant critical care conditions evaluated the approaches to and definitions of TTM quality with respect to fever prevention and the maintenance of precise temperature control. Current evidence on the quality of fever management associated with TTM in cardiac arrest, traumatic brain injury, stroke, sepsis, and critical care more generally was examined...
May 22, 2023: Therapeutic Hypothermia and Temperature Management
https://read.qxmd.com/read/37048710/optimal-timing-of-targeted-temperature-management-for-post-cardiac-arrest-syndrome-is-sooner-better
#7
JOURNAL ARTICLE
I-Ting Wang, Chieh-Jen Wang, Chao-Hsien Chen, Sheng-Hsiung Yang, Chun-Yen Chen, Yen-Chun Huang, Chang-Yi Lin, Chien-Liang Wu
Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients' outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who received TTM from July 2015 to July 2021 at our hospital. The values of time delay before TTM and time to target temperature were divided into three periods according to optimal cut-off values identified using receiver operating characteristic curve analysis...
March 31, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/36964887/temperature-control-after-cardiac-arrest-a-narrative-review
#8
REVIEW
Samantha Fernandez Hernandez, Brooke Barlow, Vera Pertsovskaya, Carolina B Maciel
Cardiac arrest (CA) is a critical public health issue affecting more than half a million Americans annually. The main determinant of outcome post-CA is hypoxic-ischemic brain injury (HIBI), and temperature control is currently the only evidence-based, guideline-recommended intervention targeting secondary brain injury. Temperature control is a key component of a post-CA care bundle; however, conflicting evidence challenges its wide implementation across the vastly heterogeneous population of CA survivors. Here, we critically appraise the available literature on temperature control in HIBI, detail how the evidence has been integrated into clinical practice, and highlight the complications associated with its use and the timing of neuroprognostication after CA...
March 25, 2023: Advances in Therapy
https://read.qxmd.com/read/36779060/opportunities-and-barriers-to-translating-the-hibernation-phenotype-for-neurocritical-care
#9
REVIEW
Kelly L Drew, Saurav Bhowmick, Bernard W Laughlin, Anna V Goropashnaya, Øivind Tøien, M Hoshi Sugiura, Ardy Wong, Kambiz Pourrezaei, Zeinab Barati, Chao-Yin Chen
Targeted temperature management (TTM) is standard of care for neonatal hypoxic ischemic encephalopathy (HIE). Prevention of fever, not excluding cooling core body temperature to 33°C, is standard of care for brain injury post cardiac arrest. Although TTM is beneficial, HIE and cardiac arrest still carry significant risk of death and severe disability. Mammalian hibernation is a gold standard of neuroprotective metabolic suppression, that if better understood might make TTM more accessible, improve efficacy of TTM and identify adjunctive therapies to protect and regenerate neurons after hypoxic ischemia brain injury...
2023: Frontiers in Neurology
https://read.qxmd.com/read/36691075/temperature-control-in-adults-after-cardiac-arrest-a-survey-of-current-clinical-practice-in-germany
#10
JOURNAL ARTICLE
Kevin Roedl, Sebastian Wolfrum, Guido Michels, Martin Pin, Gerold Söffker, Uwe Janssens, Stefan Kluge
BACKGROUND: Temperature control is recommended after out of hospital cardiac arrest (OHCA) by international guidelines. This survey aimed to investigate current clinical practice and areas of uncertainty. METHODS: Online survey targeting members of three medical emergency and critical care societies in Germany (April 21-June 6, 2022) assessing post-cardiac arrest temperature control management. RESULTS: Of 341 completed questionnaires 28% (n = 97) used temperature control with normothermic target and 72% (n = 244) temperature control with hypothermic target...
January 23, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/36454812/management-of-comatose-survivors-of-out-of-hospital-cardiac-arrest-in-europe-current-treatment-practice-and-adherence-to-guidelines-a-joint-survey-by-the-association-for-acute-cardiovascular-care-acvc-of-the-esc-the-european-resuscitation-council-erc-the-european
#11
JOURNAL ARTICLE
Pablo Jorge-Perez, Nikolaos Nikolaou, Katia Donadello, Abdo Khoury, Wilhelm Behringer, Christian Hassager, Bernd Boettiger, Alessandro Sionis, Jerry Nolan, Alain Combes, Tom Quinn, Susanna Price, Johannes Grand
AIMS: International guidelines give recommendations for the management of comatose out-of-hospital cardiac arrest (OHCA) survivors. We aimed to investigate adherence to guidelines and disparities in the treatment of OHCA in hospitals in Europe. METHODS AND RESULTS: A web-based, multi-institutional, multinational survey in Europe was conducted using an electronic platform with a predefined questionnaire developed by experts in post-resuscitation care. The survey was disseminated to all members of the societies via email, social media, websites, and newsletters in June 2021...
February 9, 2023: European Heart Journal. Acute Cardiovascular Care
https://read.qxmd.com/read/36380332/speed-of-cooling-after-cardiac-arrest-in-relation-to-the-intervention-effect-a-sub-study-from-the-ttm2-trial
#12
RANDOMIZED CONTROLLED TRIAL
Rupert F G Simpson, Josef Dankiewicz, Grigoris V Karamasis, Paolo Pelosi, Matthias Haenggi, Paul J Young, Janus Christian Jakobsen, Jonathan Bannard-Smith, Pedro D Wendel-Garcia, Fabio Silvio Taccone, Per Nordberg, Matt P Wise, Anders M Grejs, Gisela Lilja, Roy Bjørkholt Olsen, Alain Cariou, Jean Baptiste Lascarrou, Manoj Saxena, Jan Hovdenes, Matthew Thomas, Hans Friberg, John R Davies, Niklas Nielsen, Thomas R Keeble
BACKGROUND: Targeted temperature management (TTM) is recommended following cardiac arrest; however, time to target temperature varies in clinical practice. We hypothesised the effects of a target temperature of 33 °C when compared to normothermia would differ based on average time to hypothermia and those patients achieving hypothermia fastest would have more favorable outcomes. METHODS: In this post-hoc analysis of the TTM-2 trial, patients after out of hospital cardiac arrest were randomized to targeted hypothermia (33 °C), followed by controlled re-warming, or normothermia with early treatment of fever (body temperature, ≥ 37...
November 15, 2022: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/36291308/intra-arrest-therapeutic-hypothermia-and-neurologic-outcome-in-patients-admitted-after-out-of-hospital-cardiac-arrest-a-post-hoc-analysis-of-the-princess-trial
#13
JOURNAL ARTICLE
Elisabetta Macchini, Emelie Dillenbeck, Martin Jonsson, Filippo Annoni, Sune Forsberg, Jacob Hollenberg, Anatolij Truhlar, Leif Svensson, Per Nordberg, Fabio Silvio Taccone
Background : Despite promising results, the role of intra-arrest hypothermia in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim of this study was to assess the effects of trans-nasal evaporative cooling (TNEC) during resuscitation on neurological recovery in OHCA patients admitted alive to the hospital. Methods : A post hoc analysis of the PRINCESS trial, including only patients admitted alive to the hospital, either assigned to TNEC or standard of care during resuscitation. The primary endpoint was favorable neurological outcome (FO) defined as a Cerebral Performance Category (CPC) of 1-2 at 90 days...
October 10, 2022: Brain Sciences
https://read.qxmd.com/read/36252353/the-monoacylglycerol-lipase-inhibitor-jzl184-has-comparable-effects-to-therapeutic-hypothermia-attenuating-global-cerebral-injury-in-a-rat-model-of-cardiac-arrest
#14
JOURNAL ARTICLE
Jing Xu, Guanghui Zheng, Juntao Hu, Weiwei Ge, Jennifer L Bradley, Joseph P Ornato, Wanchun Tang
Post-resuscitation cerebral ischemia-reperfusion injury (IRI) is a vital contributor to poor neurological prognosis. Exploring novel therapeutics that attenuate cerebral IRI is of great significance. Inflammation plays a role in the development of cerebral IRI after successful cardiopulmonary resuscitation (CPR). Monoacylglycerol lipase (MAGL) is an enzyme that is predominantly responsible for the metabolism of endocannabinoid 2-arachidonoylglycerol (2-AG) to arachidonic acid (AA) metabolites, which are associated with inflammation...
October 14, 2022: Biomedicine & Pharmacotherapy
https://read.qxmd.com/read/36118997/targeted-temperature-management-after-cardiac-arrest-a-systematic-review
#15
REVIEW
Aakash Bisht, Ankit Gopinath, Ameer Haider Cheema, Keyur Chaludiya, Maham Khalid, Marcellina Nwosu, Walter Y Agyeman, Ana P Arcia Franchini
Targeted temperature management (TTM) has been the cornerstone of post-cardiac arrest care, but even after therapy, neurological outcomes remain poor. We performed a systematic review to evaluate the influence of TTM in post-cardiac arrest treatment, its effect on the neurological outcome, survival, and the adverse events associated with it. We also aimed to examine any difference between the effect of therapy at various intensities and durations on the prognosis of the patient. A search of two databases was done to find relevant studies, followed by a thorough screening in which the inclusion and exclusion criteria were applied, and a quality appraisal of clinical trials was done...
September 2022: Curēus
https://read.qxmd.com/read/35795804/selective-brain-cooling-a-new-horizon-of-neuroprotection
#16
REVIEW
Ji Man Hong, Eun Sil Choi, So Young Park
Therapeutic hypothermia (TH), which prevents irreversible neuronal necrosis and ischemic brain damage, has been proven effective for preventing ischemia-reperfusion injury in post-cardiac arrest syndrome and neonatal encephalopathy in both animal studies and clinical trials. However, lowering the whole-body temperature below 34°C can lead to severe systemic complications such as cardiac, hematologic, immunologic, and metabolic side effects. Although the brain accounts for only 2% of the total body weight, it consumes 20% of the body's total energy at rest and requires a continuous supply of glucose and oxygen to maintain function and structural integrity...
2022: Frontiers in Neurology
https://read.qxmd.com/read/35763192/computational-modeling-of-targeted-temperature-management-in-post-cardiac-arrest-patients
#17
JOURNAL ARTICLE
Maja Duh, Kristijan Skok, Matjaž Perc, Andrej Markota, Marko Gosak
Our core body temperature is held around [Formula: see text]C by an effective internal thermoregulatory system. However, various clinical scenarios have a more favorable outcome under external temperature regulation. Therapeutic hypothermia, for example, was found beneficial for the outcome of resuscitated cardiac arrest patients due to its protection against cerebral ischemia. Nonetheless, practice shows that outcomes of targeted temperature management vary considerably in dependence on individual tissue damage levels and differences in therapeutic strategies and protocols...
June 28, 2022: Biomechanics and Modeling in Mechanobiology
https://read.qxmd.com/read/35131119/erc-esicm-guidelines-on-temperature-control-after-cardiac-arrest-in-adults
#18
JOURNAL ARTICLE
Jerry P Nolan, Claudio Sandroni, Lars W Andersen, Bernd W Böttiger, Alain Cariou, Tobias Cronberg, Hans Friberg, Cornelia Genbrugge, Gisela Lilja, Peter T Morley, Nikolaos Nikolaou, Theresa M Olasveengen, Markus B Skrifvars, Fabio S Taccone, Jasmeet Soar
The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society...
March 2022: Resuscitation
https://read.qxmd.com/read/35089409/erc-esicm-guidelines-on-temperature-control-after-cardiac-arrest-in-adults
#19
JOURNAL ARTICLE
Claudio Sandroni, Jerry P Nolan, Lars W Andersen, Bernd W Böttiger, Alain Cariou, Tobias Cronberg, Hans Friberg, Cornelia Genbrugge, Gisela Lilja, Peter T Morley, Nikolaos Nikolaou, Theresa M Olasveengen, Markus B Skrifvars, Fabio S Taccone, Jasmeet Soar
The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society...
March 2022: Intensive Care Medicine
https://read.qxmd.com/read/35010760/accidental-hypothermia-2021-update
#20
REVIEW
Peter Paal, Mathieu Pasquier, Tomasz Darocha, Raimund Lechner, Sylweriusz Kosinski, Bernd Wallner, Ken Zafren, Hermann Brugger
Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available...
January 3, 2022: International Journal of Environmental Research and Public Health
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