Therapeutic hypothermia and temperature management最新文献

{"title":"The Association Between Neonatal Intensive Care Unit Arrival Temperatures and Short-Term Outcomes of Neonates with Moderate and Severe Hypoxic-Ischemic Encephalopathy.","authors":"Zehra Arslan, Asli Okbay Gunes, Mehmet Fatih Deveci, Ayse Unal Yuksekgonul, Kamber Kasali","doi":"10.1089/ther.2024.0021","DOIUrl":"10.1089/ther.2024.0021","url":null,"abstract":"<p><p>Therapeutic hypothermia (TH) is the only treatment method that is known to reduce mortality and neurological sequela rates in newborns with moderate and severe hypoxic-ischemic encephalopathy (HIE). We aimed to evaluate the relationship between rectal temperatures measured upon arrival to our unit and short-term outcomes in newborns with HIE/TH. This was a retrospective study conducted between January 2022 and January 2023. The neonates were divided into three groups according to their rectal temperatures measured upon arrival at our unit as follows: Group 1) <33°C, Group 2) 33-34°C (group arriving at target temperature), and Group 3) >34°C. Short-term outcomes and mortality were compared between the groups. Group 1 consisted of 17 (19.8%) neonates, Group 2 consisted of 34 (39.5%) neonates, and Group 3 consisted of 35 (40.7%) neonates who had HIE and an indication for TH. Rectal temperature on arrival to the unit was not related to the rate of clinical convulsions, rates of abnormal attenuated electroencephalography and magnetic resonance imaging findings, rate of pulmonary hypertension, duration of mechanical ventilation and length of hospital stay. Although the mortality rate was 29% in Group 1, it was 3% and 6% in Groups 2 and 3, respectively (<i>p</i> = 0.016). No relationship was found between the rectal temperature upon arrival to the NICU and the short-term outcomes in HIE/TH neonates. However, the mortality rate in those who were overcooled was significantly higher compared with the other groups.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"62-68"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Pulmonary Hypertension During Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy and Evaluation of Short-Term Outcomes.","authors":"Rashida Javed, James Hodson, Harsha Gowda","doi":"10.1089/ther.2024.0023","DOIUrl":"10.1089/ther.2024.0023","url":null,"abstract":"<p><p>Infants with perinatal asphyxia and moderate-to-severe hypoxic ischemic encephalopathy (HIE) are currently treated with therapeutic hypothermia (TH) as part of a brain protective strategy. However, perinatal asphyxia is a risk factor for development of persistent pulmonary hypertension (PPHN). As such, the aim of this study was to quantify the risk of PPHN in infants undergoing TH and assess short-term outcomes in infants developing PPHN. All <i>N</i> = 59 infants undergoing TH for moderate-to-severe HIE over a period of 3 years (January 2020-December 2022) at a single center were included. PPHN was diagnosed in <i>N</i> = 10 (17%), with this deemed to have been exacerbated by TH in <i>n</i> = 6 (10%). Only 50% (5/10) with PPHN required inhaled nitric oxide, and none of the infants received extracorporeal membrane oxygenation. PPHN was not found to be significantly associated with short-term outcomes, including the extent of HIE on brain magnetic resonance imagings, in-hospital mortality or requirement for nasogastric feeding at discharge. In conclusion, TH appears to be a safe and effective treatment for moderate-to-severe HIE with or without PPHN.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"69-73"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Correlation Between Preoperative Perfusion Index and Intraoperative Hypothermia During Laparoscopic Radical Surgery for Urological Malignancies.","authors":"Yingying Zhang, Yuxiao Li, Fengxia Chen","doi":"10.1089/ther.2024.0035","DOIUrl":"10.1089/ther.2024.0035","url":null,"abstract":"<p><p>This study aimed to explore the relationship between preoperative baseline perfusion index (PI) and intraoperative hypothermia during general anesthesia. PI reflects the peripheral perfusion status, which may be associated with the decrease of core temperature during general anesthesia, as the redistribution of temperature from the core compartment to the peripheral compartment depends on the peripheral perfusion status. A total of 68 patients underwent radical surgery for urological malignancies in this study. The baseline PI value was measured upon entering the operating room. Core temperature was continuously monitored using a nasal pharyngeal probe from anesthesia induction to the end of surgery, with temperature data recorded every 15 minutes. Univariate and multivariate logistic regression analyses were used to identify risk factors for intraoperative hypothermia. Intraoperative hypothermia occurred in 26 patients, whose baseline PI (2.70 ± 0.73) was significantly lower than that of the normothermic group (3.65 ± 1.05), with <i>P</i><0.05. The baseline PI was independently associated with intraoperative hypothermia (PI: [OR] 0.375, 95% confidence interval [CI]: 1.584-6.876, <i>p</i> = 0.001). This study suggests that low baseline PI is an independent factor associated with intraoperative hypothermia. In future studies, PI value could be considered as a predictor for the treatment of intraoperative hypothermia.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"82-88"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory Feasibility Study of Cerebral Cooling by Transpulmonary Cooling During Cardiac Arrest in a Swine Cardiac Arrest Model.","authors":"Atsushi Sakurai, Yoshihisa Kato, Haruka Uki, Kana Yagi, Atsushi Watanabe, Jun Sato, Katsuhiro Nakagawa, Hayato Nakabayashi, Kosaku Kinoshita","doi":"10.1089/ther.2024.0017","DOIUrl":"10.1089/ther.2024.0017","url":null,"abstract":"<p><p>Studies on targeted temperature management for postcardiac arrest syndrome have shown no difference in outcomes between normothermia and hypothermia in patients with postcardiac arrest brain injury. Therefore, further development of therapeutic methods for temperature control in cardiac arrest patients is desirable. Although animal studies have shown that inducing hypothermia during cardiac arrest improves outcomes, no clinically effective method has yet been reported. We investigated whether intra-arrest lung cooling (IALC) effectively lowers brain temperature. A device capable of cooling oxygen was developed. The pigs were subjected to cardiac arrest using the device, ventilated, cooled during cardiopulmonary resuscitation, and resuscitated for 1 hour, with changes in brain temperature closely monitored. A device capable of cooling oxygen to -30°C was used to cool the lungs during cardiac arrest. Through this approach, IALC successfully reduced the brain temperature. Optimal cooling efficiency was observed when chest compressions and ventilation were synchronized at a ratio of 5:1, resulting in an approximate brain temperature reduction of 1.5°C/h. Our successful development of an oxygen-cooling device underscores the potential for lowering brain temperature through IALC using inhaled oxygen cooling.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"55-61"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy-Drift in Clinical Practice in Swiss Neonatal (Intensive Care) Units?","authors":"Charlotte Lengauer, Mark Adams, Barbara Brotschi, Michael Kleber, Vera Bernet, Maren Tomaske, Dirk Bassler, Beate Grass","doi":"10.1089/ther.2025.0019","DOIUrl":"https://doi.org/10.1089/ther.2025.0019","url":null,"abstract":"<p><p>The objective of this study was to assess the adherence to inclusion criteria for therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to survey current attitudes on TH. This multicenter observational study therefore combined a retrospective analysis of the Swiss National Asphyxia and Cooling Register (2011-2023) and a prospective survey (2024) among neonatologists in the Canton of Zurich, Switzerland. A total of 456 neonates with HIE were registered in the Swiss National Asphyxia and Cooling Register in the Canton of Zurich, Switzerland, between 2011 and 2023. The rate of TH (52.6% [2011-2017] versus 52.0% [2018-2023]) as well as the incidence of off-protocol cooling remained stable over time (<i>p</i> = 0.614). The survey response rate was 69.5% (57/82). Difficulties with clinical grading of encephalopathy were identified. Subjectively, respondents considered themselves more generous to initiate TH. In conclusion, register data reflected good adherence to inclusion criteria for TH. The survey confirmed willingness to consider TH in milder HIE cases. However, there was no drift in clinical practice-yet?</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heated High-Flow Nasal Cannula for the Treatment of Unintended Perioperative Hypothermia: A Feasibility Study.","authors":"Kirklen Petersen, Spencer Rice, Kenneth Potter, Shannon Boylan, Kristina Clark, Megan McCartney, Laura Lahaye","doi":"10.1089/ther.2025.0010","DOIUrl":"https://doi.org/10.1089/ther.2025.0010","url":null,"abstract":"<p><p>There are many established strategies to target normothermia in the perioperative period; however, hypothermia remains a common occurrence and can have significant impacts on patient outcomes, unanticipated admissions, and postanesthesia care unit (PACU) throughput. This pilot study serves to shed light on the effectiveness of using high-flow nasal cannula (HFNC) as an alternative to a Bair Hugger (BH). This pilot study compares 10 patients warmed to normothermia with HFNC in the PACU with 15 patients warmed with traditional BH. Patients in the HFNC group reached the goal temperature of 36°C 9.1 minutes faster than the BH group. However, these findings were not statistically significant (mean time: 72.1 minutes vs 81.2; <i>p</i> = 0.247). In addition, phase 1 recovery times were about 8 minutes longer in the HFNC group compared with the BH group but were also not statistically significant (mean time: 180.8 minutes vs 172.4; <i>p</i> = 0.338). Based on the initial data, HFNC may play an important role in the future by making PACU rewarming more efficient and therefore having a huge impact on PACU discharge times, unanticipated hospital admissions, delayed emergence from anesthesia, and morbid cardiac events. Further large scale, randomized control studies need to be done to investigate HFNC as an alternative rewarming method for hypothermic patients in the PACU.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Internal Validation of a Risk Model to Estimate Probability of Intraoperative Hypothermia in Adult Surgical Patients.","authors":"Wenjun Liu, Xuetao Jiang, Haolin Zhang, Guiying Yang","doi":"10.1089/ther.2024.0058","DOIUrl":"https://doi.org/10.1089/ther.2024.0058","url":null,"abstract":"<p><p>Intraoperative hypothermia is associated with various perioperative complications and an increased risk of mortality. This study aims to develop and validate a reliable risk model, the Intraoperative Hypothermia Risk Estimating Model (IHREM), for assessing the likelihood of intraoperative hypothermia in adult patients receiving different types of surgery and anesthesia. Data from 1815 surgical patients were collected, with 1521 used to develop the IHREM training set. Univariate logistic regression was utilized to evaluate the parameters included in the study. For the first time, parameters showing non-linear associations with the risk of intraoperative hypothermia were evaluated and then incorporated into a primary model using restricted cubic splines (RCS), based on the result of multivariate logistic regression. The final model was comprised of 12 risk factors, including body mass index (BMI), fasting time, preoperative heart rate, preoperative tympanic temperature, intravenous fluid administration volume, intraoperative irrigation volume, estimated blood loss, duration of anesthesia, surgical position, intraoperative warming, operation room temperature, and humidity. The IHREM model demonstrated satisfactory performance in the training set, exhibiting reliable discrimination, calibration, overall performance, and clinical utility. In the temporal validation set (<i>n</i> = 294), the c-index, calibration intercept and calibration slope, Brier score, and <i>R</i>² were determined to be 0.763 (95% CI, 0.710-0.819), 0.394 (95% CI, 0.118-0.680), 0.865 (95% CI, 0.638-1.114), 0.204 (95% CI, 0.180-0.229), and 0.236, respectively. Meanwhile, decision curve analysis and clinical impact curve showed that IHREM provides promising clinical value. In addition, RCS analysis indicated that maintaining the operation room temperature above 20°C is sufficient to prevent hypothermia while increasing or sustaining the preoperative core temperature to around 36.7-36.8°C significantly reduces the risk of hypothermia. IHREM holds promise as a valuable tool for identifying adult patients at risk of intraoperative hypothermia under various types of surgery and anesthesia, thereby supporting clinical decision-making.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryotherapy Is Effective in Nulliparous Women with Primary Dysmenorrhea: A Randomized Controlled Trial.","authors":"Borja Perez-Dominguez, Lucia Gonzalez-Ruiz, Sara Muñoz-Ibañez, Maria Blanco-Diaz, Esther Diaz-Mohedo","doi":"10.1089/ther.2025.0008","DOIUrl":"https://doi.org/10.1089/ther.2025.0008","url":null,"abstract":"<p><p>Primary dysmenorrhea is a prevalent condition causing severe menstrual pain in nulliparous women, negatively impacting daily functioning and well-being. This randomized controlled trial investigated the efficacy of cryotherapy in alleviating pain and enhancing secondary outcomes such as sleep quality, quality of life, and physical activity. Fifty-eight nulliparous women were randomly assigned to a cryotherapy group or a control group. Pain intensity was measured using the Numeric Rating Scale, whereas secondary outcomes were evaluated with the Pittsburgh Sleep Quality Index, World Health Organization Quality of Life-Brief Version, and the International Physical Activity Questionnaire. Socioeconomic factors, including household income, education, and occupation, were also assessed. Cryotherapy significantly reduced pain intensity from a baseline of 7.1 ± 1.4 to 1.8 ± 1.7 (<i>p</i> < 0.001) compared with a modest reduction in the control group (5.9 ± 1.9-5.4 ± 2.1). Sleep quality improved more in the cryotherapy group (6.90 ± 3.0 to 5.03 ± 2.5) than in the control group (6.88 ± 3.6 to 5.68 ± 2.8). However, no statistically significant changes were observed in the quality of life or physical activity levels, likely because menstrual pain alone may not sufficiently influence these domains, which are affected by broader psychosocial and behavioral factors. These findings demonstrate that cryotherapy is a simple, cost-effective intervention for managing primary dysmenorrhea, providing substantial pain relief and modest improvements in sleep quality. Further research is recommended to evaluate its long-term benefits and potential for broader applications in menstrual health management.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Hypothermia Versus Normothermia in Breast Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Teuku N Putra, Iqbal F Sayudo, Jesica P Sudarman, Krish Krish, Swathi Vellaichamy, Islah Nadila, Marcílio O Filho","doi":"10.1089/ther.2024.0038","DOIUrl":"10.1089/ther.2024.0038","url":null,"abstract":"<p><p>Despite advancements in breast reconstruction, the precise impact of intraoperative hypothermia on postoperative complications remains unclear. Recent literature suggests that intraoperative hypothermia is a risk factor for impaired wound healing and increases the incidence of surgical site infections. This study examines the effect of intraoperative hypothermia on postoperative outcomes in breast reconstruction. We searched PubMed, Embase, and Cochrane Library for studies comparing hypothermia with normothermia in breast reconstruction. A meta-analytical method was employed to estimate the risk of postoperative complications among patients undergoing breast reconstruction. Data synthesis employed the random-effects models, presenting the results as risk ratio (RR) with corresponding 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration), and heterogeneity was assessed using I² statistics. Four studies meeting our inclusion criteria were included in the meta-analysis, comprising 871 participants. The average age and body mass index were 52.98 years and 27.76 kg/m², with a follow-up duration of 3-6 months. In our analysis, intraoperative hypothermia was associated with an increase in the incidence of wound healing complications in breast reconstruction (RR 1.68; 95% CI 1.24 to 2.27; <i>p</i> = 0.0008). Despite lower incidence of infection, hematoma, seroma, and necrosis in the hypothermia group, no significant differences were observed. Our meta-analysis assessing intraoperative hypothermia in breast reconstruction indicates that hypothermia is a significant risk factor for wound healing complications.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"10-16"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/ther.2024.58635.revack","DOIUrl":"https://doi.org/10.1089/ther.2024.58635.revack","url":null,"abstract":"","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"15 1","pages":"53"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}