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Latest & greatest articles for hypothermia
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Mild intraoperative hypothermia during surgery for intracranial aneurysm. 15647576 2005 01 13 2005 01 21 2016 08 31 1533-4406 352 2 2005 Jan 13 The New England journal of medicine N. Engl. J. Med. Mild intraoperative hypothermia during surgery for intracranial aneurysm. 135-45 Surgery for intracranial aneurysm often results in postoperative neurologic deficits. We conducted a randomized trial at 30 centers to determine whether intraoperative cooling during open craniotomy would improve (...) the outcome among patients with acute aneurysmal subarachnoid hemorrhage. A total of 1001 patients with a preoperative World Federation of Neurological Surgeons score of I, II, or III ("good-grade patients"), who had had a subarachnoid hemorrhage no more than 14 days before planned surgical aneurysm clipping, were randomly assigned to intraoperative hypothermia (target temperature, 33 degrees C, with the use of surface cooling techniques) or normothermia (target temperature, 36.5 degrees C). Patients were
Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. 16221780 2005 10 13 2005 10 18 2016 10 19 1533-4406 353 15 2005 Oct 13 The New England journal of medicine N. Engl. J. Med. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. 1574-84 Hypothermia is protective against brain injury after asphyxiation in animal models. However, the safety and effectiveness of hypothermia in term infants with encephalopathy is uncertain. We conducted a randomized trial (...) of hypothermia in infants with a gestational age of at least 36 weeks who were admitted to the hospital at or before six hours of age with either severe acidosis or perinatal complications and resuscitation at birth and who had moderate or severe encephalopathy. Infants were randomly assigned to usual care (control group) or whole-body cooling to an esophageal temperature of 33.5 degrees C for 72 hours, followed by slow rewarming (hypothermia group). Neurodevelopmental outcome was assessed at 18 to 22 months
Therapeutic hypothermia after out of hospital cardiac arrest BestBets: Therapeutic hypothermia after out-of-hospital cardiac arrest Therapeutic hypothermia after out-of-hospital cardiac arrest Report By: Bernard A Fo�x - Consultant in Emergency Medicine and Critical Care Search checked by John Butler - Consultant in Emergency Medicine and Critical Care Institution: Department of Emergency Medicine, Manchester Royal Infirmary Date Submitted: 27th August 2003 Date Completed: 1st September 2004 (...) Last Modified: 1st September 2004 Status: Green (complete) Three Part Question In [adults who have sustained an out-of-hospital cardiac arrest] does [therapeutic hypothermia] [improve outcome]? Clinical Scenario A 46 year old father of three collapses in the street with a cardio-respiratory arrest. He receives five minutes of bystander CPR. When the ambulance crew arrives he is in VF. Return of spontaneous circulation is achieved after defibrillation. On arrival in the emergency department he
Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review McIntyre L A, Fergusson D A, Hebert P C, Moher D, Hutchison J S CRD summary This well conducted review evaluated the use of therapeutic hypothermia as a neuroprotective strategy after severe traumatic brain injury (...) in adults. Although therapeutic hypothermia might reduce the risks of death and poor neurological outcome, the authors' stated that there was insufficient evidence to recommend its routine use in clinical practice. The authors' were appropriately cautious in their conclusions. Authors' objectives To investigate the effects of depth, duration and rate of rewarming after discontinuation of hypothermia on mortality and neurological outcome in adults following traumatic brain injury (TBI). Searching A range
Management of profound hypothermia in children without the use of extracorporeal life support therapy. Profound hypothermia is managed more and more with extracorporeal life support technology, especially when a patient's circulation is compromised. Many centres do not have rapid access to this service, however, and are still dependent on active internal rewarming techniques--eg, peritoneal and pleural lavage. Such interventions are invasive, and associated with inherent risk. Here, we report (...) our successful experience with an active external rewarming technique in children with profound hypothermia (core temperature <20 degrees C).
The role of hypothermia in the management of severe brain injury: a meta-analysis The role of hypothermia in the management of severe brain injury: a meta-analysis The role of hypothermia in the management of severe brain injury: a meta-analysis Harris O A, Colford J M, Good M C, Matz P G Authors' objectives To determine the effectiveness of hypothermia in the management of severe brain injury. Searching MEDLINE, the Cochrane Database of Systematic Reviews, EMBASE and the abstract centre (...) of hypothermia in the management of severe head injury, compared with normothermia, were eligible for inclusion. In the included studies, the temperature of hypothermia ranged from 32 to 35 degrees C and the duration of hypothermia was between 24 hours and 14 days. The time to target temperature, where reported, ranged from 8 to 15 hours post-injury and the rewarming schedule varied between 12 hours and 5 days. Participants included in the review Studies of participants aged 10 years or older with post
Effects of therapeutic hypothermia on intracranial pressure and outcome in patients with severe head injury PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. 11856793 2002 02 21 2002 03 05 2006 11 15 1533-4406 346 8 2002 Feb 21 The New England journal of medicine N. Engl. J. Med. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. 549-56 Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment. We studied whether mild systemic hypothermia increases the rate of neurologic recovery after (...) resuscitation from cardiac arrest due to ventricular fibrillation. In this multicenter trial with blinded assessment of the outcome, patients who had been resuscitated after cardiac arrest due to ventricular fibrillation were randomly assigned to undergo therapeutic hypothermia (target temperature, 32 degrees C to 34 degrees C, measured in the bladder) over a period of 24 hours or to receive standard treatment with normothermia. The primary end point was a favorable neurologic outcome within six months
Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. 11856794 2002 02 21 2002 03 05 2009 08 04 1533-4406 346 8 2002 Feb 21 The New England journal of medicine N. Engl. J. Med. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. 557-63 Cardiac arrest outside the hospital is common and has a poor outcome. Studies in laboratory animals suggest that hypothermia induced shortly after the restoration of spontaneous (...) circulation may improve neurologic outcome, but there have been no conclusive studies in humans. In a randomized, controlled trial, we compared the effects of moderate hypothermia and normothermia in patients who remained unconscious after resuscitation from out-of-hospital cardiac arrest. The study subjects were 77 patients who were randomly assigned to treatment with hypothermia (with the core body temperature reduced to 33 degrees C within 2 hours after the return of spontaneous circulation
Therapeutic hypothermia for head injury. BACKGROUND: Induced hypothermia has been used in the treatment of head injury for many years. Encouraging results from small trials and laboratory studies led to renewed interest in the area and some larger trials. OBJECTIVES: To estimate the effects of mild induced hypothermia in moderate and severe head injury on mortality, long-term functional outcome, complications, and short-term control of intracranial pressure (ICP). SEARCH STRATEGY: We searched (...) the Injuries Group Specialised register (last searched in 2001), Medline, EMBASE and the Cochrane Controlled Trials Register. We handsearched conference proceedings and checked reference lists of relevant articles. SELECTION CRITERIA: Randomised controlled trials of mild hypothermia to 34-35 Celsius for a t least 12 hours versus control (open or normothermia) in patients with any closed head injury requiring hospitalisation. Two reviewers independently assessed all trials. DATA COLLECTION AND ANALYSIS
Lack of effect of induction of hypothermia after acute brain injury. 11207351 2001 02 09 2001 02 22 2007 11 14 0028-4793 344 8 2001 Feb 22 The New England journal of medicine N. Engl. J. Med. Lack of effect of induction of hypothermia after acute brain injury. 556-63 Induction of hypothermia in patients with brain injury was shown to improve outcomes in small clinical studies, but the results were not definitive. To study this issue, we conducted a multicenter trial comparing the effects (...) of hypothermia with those of normothermia in patients with acute brain injury. The study subjects were 392 patients 16 to 65 years of age with coma after sustaining closed head injuries who were randomly assigned to be treated with hypothermia (body temperature, 33 degrees C), which was initiated within 6 hours after injury and maintained for 48 hours by means of surface cooling, or normothermia. All patients otherwise received standard treatment. The primary outcome measure was functional status six months
Hypothermia to reduce neurological damage following coronary artery bypass surgery. BACKGROUND: Coronary artery bypass surgery (CABG) may be life saving, but known side effects include neurological damage and cognitive impairment. The temperature used during cardiopulmonary bypass (CPB) may be important with regard to these adverse outcomes, where hypothermia is used as a means of neuroprotection. OBJECTIVES: To assess the effectiveness of hypothermia during CABG in reducing neurological damage (...) hypothermia protocol was considered. Only trials reporting neurological outcomes were included. DATA COLLECTION AND ANALYSIS: Studies were selected independently and data were extracted from the source papers independently by two reviewers. Authors were contacted for further information. Studies were combined with meta-analysis where appropriate, and meta-regression was used to explore heterogeneity. MAIN RESULTS: There was a trend towards a reduction in the incidence of non fatal strokes
Therapeutic hypothermia for head injury. BACKGROUND: Mild to moderate induced hypothermia has been used in the treatment of head injury for over 50 years, although few randomised controlled trials have been performed. Recent encouraging results from small, single-centre trials and consistent findings of a cerebral protection effect of cooling in laboratory models of global ischaemia has led to a renewed interest in the area. OBJECTIVES: To determine whether the use of mild therapeutic (...) hypothermia in the treatment of moderate and severe head injury improves short-term control of intracranial pressure (ICP) and long-term functional outcome. SEARCH STRATEGY: Electronic searches of the Injuries Group trial registry and EMBASE for any relevant randomised trials, supplemented by hand searching of conference proceedings and reference lists of relevant articles. SELECTION CRITERIA: All randomised controlled trials of mild hypothermia versus control (open or normothermia) in the treatment