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Hypothermia neuroprotection

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https://www.readbyqxmd.com/read/28099429/vitamin-d-insufficiency-in-neonatal-hypoxic-ischemic-encephalopathy
#1
Danielle W Lowe, Bruce W Hollis, Carol L Wagner, Thomas Bass, David A Kaufman, Michael J Horgan, Laurence M Givelichian, Koravangatta Sankaran, Jerome Y Yager, Lakshmi D Katikaneni, Don Wiest, Dorothea Jenkins
BACKGROUND: Vitamin D has neuroprotective and immunomodulatory properties, and deficiency is associated with worse stroke outcomes. Little is known about effects of hypoxia-ischemia or hypothermia treatment on vitamin D status in neonates with hypoxic-ischemic encephalopathy (HIE). We hypothesized vitamin D metabolism would be dysregulated in neonatal HIE altering specific cytokines involved in Th17 activation, which might be mitigated by hypothermia. METHODS: We analyzed short term relationships between 25(OH) and 1,25(OH)2 vitamin D, vitamin D binding protein, and cytokines related to Th17 function in serum samples from a multicenter randomized controlled trial of hypothermia 33(0)C for 48h after HIE birth versus normothermia in 50 infants with moderate to severe HIE...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28099423/high-dose-erythropoietin-population-pharmacokinetics-in-neonates-with-hypoxic-ischemic-encephalopathy-receiving-hypothermia
#2
Adam Frymoyer, Sandra E Juul, An N Massaro, Theo K Bammler, Yvonne W Wu
BACKGROUND: High-dose erythropoietin (Epo) is a promising neuroprotective treatment in neonates with hypoxic ischemic encephalopathy (HIE) receiving hypothermia. We evaluated the pharmacokinetics and dose-exposure relationships of high-dose Epo in this population to inform future dosing strategies. METHODS: We performed a population pharmacokinetic analysis of 47 neonates with HIE treated with hypothermia who received up to 6 doses of Epo in two previous clinical trials...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28065791/the-neuroprotective-strategic-analysis-for-patients-with-acute-myocardial-infarction-combined-with-hypoxic-ischemic-encephalopathy-in-icu
#3
Yali Chao, Weiwei Hu, Xiaojuan Geng
BACKGROUND: We conducted this study to investigate the neuroprotective treatment strategies for patients with acute myocardial infarction (AMI) complicated with hypoxic ischemic encephalopathy (HIE) in the ICU. METHODS: A total of 83 cases that were diagnosed with secondary AMI for the first time were selected and divided into observation group (n=43) and the control group (n=40). All of patients underwent emergency or elective PCI. Patients in the control group were treated with mannitol to reduce intracranial pressure, cinepazide maleate to improve microcirculation in the brain and also given comprehensive treatments of oxygen inhalation, fluid infusion, acid-base imbalance correction, electrolyte disturbance, etc...
January 5, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28062149/prediction-of-neonatal-seizures-in-hypoxic-ischemic-encephalopathy-using-electroencephalograph-power-analyses
#4
Siddharth V Jain, Amit Mathur, Preethi Srinivasakumar, Michael Wallendorf, Joseph P Culver, John M Zempel
BACKGROUND: The severity of the initial encephalopathy in neonatal hypoxic-ischemic encephalopathy correlates with seizure burden. Early electroencephalograph (EEG) background activity reflects the severity of encephalopathy. Thus, we hypothesized that early EEG background would be predictive of subsequent seizures in neonatal hypoxic-ischemic encephalopathy. METHODS: This study included infants undergoing therapeutic hypothermia at St. Louis Children's Hospital between January 2009 and April 2013...
November 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28054002/data-on-pharmacological-applications-and-hypothermia-protection-against-in-vitro-oxygen-glucose-deprivation-related-neurodegeneration-of-adult-rat-ca1-region
#5
Pınar Öz, Hale Saybaşılı
In this data article, the level of chemical neuroprotection against oxygen-glucose-deprivation (OGD)-related neurodegeneration in CA1 was analyzed using the measurements on CA1 stratum pyramidale (CA1sp) width. Adult rat hippocampal slices were incubated in OGD medium for 60 min to create a model for severe ischemic conditions. Alternatively, control slices were incubated in artificial cerebrospinal fluid (ACSF) for 60 min. A study of OGD induced neurodegeneration and partial prevention by pharmacological agents reported; baclofen, memantine and l-carnitine effects were included...
February 2017: Data in Brief
https://www.readbyqxmd.com/read/28038481/selective-brain-cooling-after-traumatic-brain-injury-effects-of-three-different-cooling-methods-case-report
#6
Thomas Westermaier, Robert Nickl, Stefan Koehler, Patrick Fricke, Christian Stetter, Stefan Mark Rueckriegel, Ralf-Ingo Ernestus
Background In experimental models of neuronal damage, therapeutic hypothermia proved to be a powerful neuroprotective method. In clinical studies of traumatic brain injury (TBI), this very distinct effect was not reproducible. Several meta-analyses draw different conclusions about whether therapeutic hypothermia can improve outcome after TBI. Adverse side effects of systemic hypothermia, such as severe pneumonia, have been held responsible by some authors to counteract the neuroprotective effect. Selective brain cooling (SBC) attempts to take advantage of the protective effects of therapeutic hypothermia without the adverse side effects of systemic hypothermia...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28025500/glucocorticoids-protect-neonatal-rat-brain-in-model-of-hypoxic-ischemic-encephalopathy-hie
#7
Benjamin Harding, Katherine Conception, Yong Li, Lubo Zhang
Hypoxic-ischemic encephalopathy (HIE) resulting from asphyxia in the peripartum period is the most common cause of neonatal brain damage and can result in significant neurologic sequelae, including cerebral palsy. Currently therapeutic hypothermia is the only accepted treatment in addition to supportive care for infants with HIE, however, many additional neuroprotective therapies have been investigated. Of these, glucocorticoids have previously been shown to have neuroprotective effects. HIE is also frequently compounded by infectious inflammatory processes (sepsis) and as such, the infants may be more amenable to treatment with an anti-inflammatory agent...
December 22, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#8
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28002714/hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#9
RANDOMIZED CONTROLLED TRIAL
Stephane Legriel, Virginie Lemiale, Maleka Schenck, Jonathan Chelly, Virginie Laurent, Fabrice Daviaud, Mohamed Srairi, Aicha Hamdi, Guillaume Geri, Thomas Rossignol, Julia Hilly-Ginoux, Julie Boisramé-Helms, Benjamin Louart, Isabelle Malissin, Nicolas Mongardon, Benjamin Planquette, Marina Thirion, Sybille Merceron, Emmanuel Canet, Fernando Pico, Yves-Roger Tran-Dinh, Jean-Pierre Bedos, Elie Azoulay, Matthieu Resche-Rigon, Alain Cariou
Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit)...
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27999623/personalized-approach-in-brain-protection-by-hypothermia-individual-changes-in-non-pathological-and-ischemia-related-glutamate-transport-in-brain-nerve-terminals
#10
Artem Pastukhov, Natalia Krisanova, Vitalii Maksymenko, Tatiana Borisova
BACKGROUND: Both deep and profound hypothermia are effectively applied in cardiac surgery of the aortic arch, when the reduction of cerebral circulation facilitates operations, and for the prevention of ischemic stroke consequences. Neurochemical discrimination of the effects of deep and profound hypothermia (27 and 17 °C, respectively) on non-pathological and pathological ischemia-related mechanisms of presynaptic glutamate transport with its potential contribution to predictive, preventive and personalized medicine (PPPM) was performed...
2016: EPMA Journal
https://www.readbyqxmd.com/read/27988510/in-the-era-of-therapeutic-hypothermia-how-well-do-studies-of-perinatal-neuroprotection-control-temperature
#11
Robert Galinsky, Justin M Dean, Christopher A Lear, Joanne O Davidson, Simerdeep Dhillon, Guido Wassink, Laura Bennet, Alistair J Gunn
In the era of therapeutic hypothermia, reliable preclinical studies are integral to successfully identify neuroprotective strategies to further improve outcomes of encephalopathy at term. We reviewed preclinical neuroprotection studies reported between January 2014 and June 2016 to assess the use of effective temperature monitoring and control. As a secondary measure, we examined whether studies addressed other methodological issues such as stage of brain development, sex differences, the timing of the treatment relative to the insult, and the histological and functional endpoints used after hypoxia-ischemia...
December 17, 2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27978510/optimizing-cerebral-autoregulation-may-decrease-neonatal-regional-hypoxic-ischemic-brain-injury
#12
Jennifer K Lee, Andrea Poretti, Jamie Perin, Thierry A G M Huisman, Charlamaine Parkinson, Raul Chavez-Valdez, Matthew O'Connor, Michael Reyes, Jillian Armstrong, Jacky M Jennings, Maureen M Gilmore, Raymond C Koehler, Frances J Northington, Aylin Tekes
BACKGROUND: Therapeutic hypothermia provides incomplete neuroprotection for neonatal hypoxic-ischemic encephalopathy (HIE). We examined whether hemodynamic goals that support autoregulation are associated with decreased brain injury and whether these relationships are affected by birth asphyxia or vary by anatomic region. METHODS: Neonates cooled for HIE received near-infrared spectroscopy autoregulation monitoring to identify the mean arterial blood pressure with optimized autoregulatory function (MAPOPT)...
December 16, 2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27907969/neuroprotection-in-critical-care-neurology
#13
Menno R Germans, Hieronymus D Boogaarts, R Loch Macdonald
Ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury-all have in common early brain injury due to brain tissue destruction, reduced cerebral blood flow and oxygen delivery, and overall substantial morbidity and mortality. The pathophysiology of brain tissue damage likely includes common cellular mechanisms. Neuroprotection has seldom, if ever, been shown to reduce early brain injury. Secondary brain injury develops after these conditions due to macroscopic events such as increased intracranial pressure and reduced cerebral blood flow, as well as cellular processes including vascular damage, inflammation, and apoptotic/necrotic cell death...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906602/meta-analysis-of-pre-clinical-trials-of-therapeutic-hypothermia-for-intracerebral-hemorrhage
#14
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
#15
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/27886883/restorative-treatments-for-spinal-cord-injury
#16
REVIEW
Stephanie Chen, Allan D Levi
Spinal cord injury remains an incurable disease with an enormous impact functionally, financially, and emotionally on affected individuals and their families. Current treatment modalities are focused on minimizing secondary injury and maximizing residual function via rehabilitation. In this article, the authors discuss ambitious advancements under investigation aimed at restoring function. These promising experimental treatments focus on neuroprotection with hypothermia and pharmacologic therapies, regeneration via cell transplantation, and rewiring with electrical stimulation...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27863707/outcomes-in-childhood-following-therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-hie
#17
REVIEW
Girija Natarajan, Athina Pappas, Seetha Shankaran
In this article, we review the childhood outcomes of neonates with birth depression and/or hypoxic-ischemic encephalopathy. The outcomes of these children prior to the era of hypothermia for neuroprotection will first be summarized, followed by discussion of results from randomized controlled trials of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy. The predictors of outcome in childhood following neonatal HIE using clinical and imaging biomarkers following hypothermia therapy will be described...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27857908/therapeutic-hypothermia-for-increased-intracranial-pressure-after-decompressive-craniectomy-a-single-center-experience
#18
Hyun Taek Rim, Jun Hyong Ahn, Ji Hee Kim, Jae Keun Oh, Joon Ho Song, In Bok Chang
OBJECTIVE: Therapeutic hypothermia (TH) and decompressive craniectomy are neuroprotective interventions following severe brain swelling. The precise benefits, risks, and clinical outcomes in brain swelling after TH are still being investigated. We aimed to investigate the effects of TH in severe brain injury after decompressive craniectomy. METHODS: We reviewed the cases of 24 patients who underwent decompressive craniectomy with intracranial pressure (ICP) monitor insertion in one medical center between January 2012 and May 2016...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27845243/in-vitro-detection-of-oxygen-and-glucose-deprivation-induced-neurodegeneration-and-pharmacological-neuroprotection-based-on-hippocampal-stratum-pyramidale-width
#19
Pınar Öz, Hale Saybaşılı
Ischemia is one of the most prominent risk factors of neurodegenerative diseases such as Alzheimer's disease. The effects of oxygen and glucose depletion in hippocampal tissue due to ischemia can be mimicked in vitro using the oxygen and glucose deprivation (OGD) model. In this study, we applied OGD on acute rat hippocampal slices in order to design an elementary yet quantitative histological technique that compares the neuroprotective effects of (l)-carnitine to known neuroprotectors, such as the N-methyl-d-aspartate (NMDA) receptor antagonist memantine and the gamma-aminobutyric acid (GABA)-B receptor agonist baclofen...
January 1, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/27834742/results-of-the-ictus-2-trial-intravascular-cooling-in-the-treatment-of-stroke-2
#20
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
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