Therapeutic hypothermia and temperature management最新文献

{"title":"The Warming Management Measures May Need to Be Further Enhanced During Scoliosis Correction and Internal Fixation Surgery: A Retrospective Cohort Study.","authors":"Hanmei Zhou, Lei Li, Qiang Li, Xiaorui Guo, Nuo Xu, Quanfu Zheng, Qiang Fu","doi":"10.1089/ther.2024.0041","DOIUrl":"10.1089/ther.2024.0041","url":null,"abstract":"<p><p>The incidence of intraoperative hypothermia (IPH) exceeds 70% during spinal surgery, which can lead to many adverse outcomes, including increased intraoperative blood loss/transfusion and delayed recovery. We aimed to evaluate the comprehensive efficiency of a kind of enhanced warming measure on patients undergoing spinal surgery. A retrospective analysis was conducted on the clinical data, surgical procedures, and outcomes of consecutive patients admitted to the department of orthopedics of a hospital from December 2019 to May 2023 and undergoing spinal surgery (scoliosis correction and internal fixation surgery). The impact of the perioperative warming measures on surgical temperature variation and postoperative recovery was analyzed. The surgical patients who received normal active warming measures (quilt, blood transfusion and infusion warming, flushing fluid warming) were the control group (Normal Warming Group [NWG], <i>n</i> = 199), and the enhanced active warming measures (NWG and forced air warming) were the experimental group (Enhanced Warming Group [EWG], <i>n</i> = 201). Incidence of IPH was the primary endpoint of this study. EWG exhibited a significantly reduced incidence of IPH and average frequency of hypothermia per patient compared with NWG (respectively, <i>p</i> < 0.01) and demonstrated notable reductions in intraoperative blood loss, urine output, anesthesia recovery time, and duration of arousal (respectively, <i>p</i> < 0.05, <i>p</i> < 0.01, and <i>p</i> < 0.001). Postoperatively, EWG showed a significantly reduced incidence of shivering (<i>p</i> < 0.001) and had lower costs for postoperative antibiotic use and albumin administration (respectively, <i>p</i> < 0.05 and <i>p</i> < 0.01). So we infer that the occurrence of hypothermia during spinal surgery may seem unavoidable, but EWG can effectively lower the occurrence of IPH and its adverse outcomes, and then somewhat alleviate the postoperative treatment burden. However, given that this study is a retrospective cohort study, it is not yet possible to definitively prove the above conclusions, so we will design relevant prospective clinical studies to prove that the optimization of temperature management may be crucial to ensure optimal overall recovery outcomes.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628863","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":"Evaluation of the Effect of Surgical Drapes on Intraoperative Hypothermia: A Randomized Clinical Trial.","authors":"Neslihan Ilkaz, Emine Iyigun","doi":"10.1089/ther.2024.0043","DOIUrl":"https://doi.org/10.1089/ther.2024.0043","url":null,"abstract":"<p><p>Many patients experience unintended hypothermia in intraoperative processes. This randomized clinical trial aims to investigate the impact of surgical drapes on hypothermia during the intraoperative period. A randomized clinical trial was conducted from April 2019 to November 2020 in the Department of Anesthesiology and Reanimation/Operating Rooms at an education and research hospital. Out of 205 patients assessed for eligibility, 74 underwent elective abdominal surgery and were randomized into two groups: nonwoven surgical drapes and woven surgical drapes. The study had two stages: preoperative and intraoperative. Preoperative data were collected using information and evaluation forms, while intraoperative assessment involved forms for wetness and weight. Tympanic and esophageal temperatures were recorded every 15 minutes, and surgical drapes were weighed with a precision scale before and after surgery. There was no significant difference between the two groups in terms of body mass index, irrigation amount, surgery duration, gender, and preoperative shivering (<i>p</i> > 0.05). A statistically significant difference was found in preoperative body temperature (36°C), type of surgery, and intraoperative hypothermia (<i>p</i> < 0.05). Both types of surgical drapes were wet, but this difference was not statistically significant between the nonwoven group (mean ± SD [1368 ± 607]) and the woven group (mean ± SD [1335 ± 636], <i>p</i> = 0.824). This study demonstrated that neither woven nor nonwoven surgical drapes, nor the wetness of the surgical drapes, had a significant effect on intraoperative hypothermia. However, there is a need for randomized controlled trials involving uniform types of surgery related to the topic.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523185","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":"Hypothermia and Influence of Rewarming Rates on Survival Among Patients Admitted to Intensive Care with Bloodstream Infection: A Multicenter Cohort Study.","authors":"Kyle C White, Lachlan Quick, Mahesh Ramanan, Alexis Tabah, Kiran Shekar, Siva Senthuran, Felicity Edwards, Antony G Attokaran, Aashish Kumar, Jason Meyer, James McCullough, Sebastiaan Blank, Christopher Smart, Peter Garrett, Kevin B Laupland","doi":"10.1089/ther.2024.0047","DOIUrl":"https://doi.org/10.1089/ther.2024.0047","url":null,"abstract":"<p><p>Although critically ill patients with bloodstream infections (BSIs) who present with hypothermia are at the highest risk for death, it is not known how rewarming rates may influence the outcomes. The objective of this study was to identify the occurrence and determinants of hypothermia among patients admitted to intensive care units (ICUs) with BSI and assess how the rate of temperature correction may influence 90-day all-cause case-fatality. A cohort of 3951 ICU admissions associated with BSI was assembled. The lowest temperature measured within the first 24 hours of admission was identified, and among those who were hypothermic (<36°C), the rewarming rate [(time difference between lowest and subsequent first temperature ≥36°C) divided by hypothermia severity (difference between lowest measured and 36°C)] was determined. Within the first 24 hours of admission to the ICU, 329 (8.4%) and 897 (22.7%) subjects had the lowest temperature measurements ranging <34.9°C and 35-35.9°C, respectively. Patients with lower temperatures were more likely to be admitted to tertiary care ICUs, have more comorbid illnesses, have greater severity of illness, and have a higher need for organ-supportive therapies. The 90-day all-cause case-fatality rate was 22.9% overall and was 45.3%, 24.8%, and 19.6% for those with the lowest 24 hours temperatures of <35°C, 35-35.9°C, and ≥36°C, respectively (<i>p</i> < 0.001). Among 1133 hypothermic patients with documented temperatures corrected to the normal range while admitted to the ICU, the median rate of temperature increase was 0.24 (interquartile range, 0.13-0.45)^oC/hour. After controlling for the severity of illness and comorbidity, a faster rewarming rate was associated with significantly lower 90-day case-fatality. Hypothermia is a significant risk factor associated with death among critically ill patients with BSI that faster rates of rewarming may modify.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508509","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":"Progress of Brain Hypothermia Treatment for Severe Subarachnoid Hemorrhage-177 Cases Experienced and a Narrative Review.","authors":"Hitoshi Kobata","doi":"10.1089/ther.2024.0037","DOIUrl":"https://doi.org/10.1089/ther.2024.0037","url":null,"abstract":"The benefits of hypothermia for the treatment of subarachnoid hemorrhage (SAH) remain controversial. In 1999, we initiated brain hypothermia treatment (BHT) in the hyperacute phase to mitigate the evolution of early brain injury in patients with World Federation of Neurological Surgeons (WFNS) grade V SAH. In June 2014, we introduced endovascular cooling to maintain normothermia for seven days following the initial BHT period. Immediately after the decision to treat the sources of bleeding, cooling was initiated, with a target temperature of 33-34°C. Bleeding sources were extirpated primarily by clipping with decompressive craniectomy. Patients were rewarmed at a rate of ≤1°C/day after ≥48 hours of surface cooling. After being rewarmed to 36°C, temperatures were controlled with antipyretic (chronologically divided into groups A-C with 47, 46, and 46 patients, respectively) or endovascular (group D, 38 patients) cooling. Overall, 177 patients (median age, 62 [52-68] years; 94 [53.1%] women; onset-to-arrival time, 36 minutes [28-50]) were included. The median Glasgow Coma Scale (GCS) score upon admission was 4 (3-6). Median core body temperature was 36 (35.3-36.6)°C on arrival, 34.6 (34.0-35.3)°C on entering the operating room, 33.8 (33.4-34.3)°C upon starting the microsurgical or interventional radiology procedure, and 33.7 (33.3-34.2)°C upon admission to the intensive care unit. There were no significant differences in age, sex, GCS score, pupillary findings, location of bleeding sources, or treatment methods. There were 69 (39.0%) overall favorable outcomes (modified Rankin Scale score of 0-3) at 6 months and 11 (23.4%), 18 (39.1%), 17 (37.0%), and 23 (60.5%) in groups A-D, respectively (p = 0.0065). The outcomes of patients with WFNS grade V SAH improved over time. Herein, we report our experience using BHT for severe SAH through a narrative review.","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"17 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221251","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":"Association Between Body Temperature and In-Hospital Mortality Among Congestive Heart Failure Patients with Diabetes in Intensive Care Unit: A Retrospective Cohort Study.","authors":"Kai Zhang, Yu Han, Fangming Gu, Zhaoxuan Gu, JiaYing Liang, JiaYu Zhao, Jianguo Chen, Bowen Chen, Min Gao, Zhengyan Hou, Xiaoqi Yu, Tianyi Cai, Yafang Gao, Rui Hu, Jinyu Xie, Tianzhou Liu, Bo Li","doi":"10.1089/ther.2023.0053","DOIUrl":"10.1089/ther.2023.0053","url":null,"abstract":"<p><p>Body temperature (BT) has been utilized to assess patient outcomes across various diseases. However, the impact of BT on mortality in the intensive care unit (ICU) among patients with congestive heart failure (CHF) and diabetes mellitus (DM) remains unclear. We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care (MIMIC)-IV data set. The primary outcome assessed was in-hospital mortality rates. BT was treated as a categorical variable in the analyses. The association between BT on ICU admission and in-hospital mortality was examined using multivariable logistic regression models, restricted cubic spline, and subgroup analysis. The cohort comprised 7063 patients with both DM and CHF (3135 females and 3928 males), with an average age of 71.5 ± 12.2 years. Comparative analysis of the reference group (Q4) revealed increased in-hospital mortality in Q6 and Q1 temperature groups, with fully adjusted odds ratios of 2.08 (95% confidence interval [CI]: 1.45-2.96) and 1.95 (95% CI: 1.35-2.79), respectively. Restricted cubic spline analysis demonstrated a U-shaped relationship between temperature on admission and mortality risk (<i>p</i> nonlinearity <0.001), with the nadir of risk observed at 36.8°C. The effect sizes and corresponding CIs below and above the threshold were 0.581 (95% CI: 0.434-0.777) and 1.674 (95% CI: 1.204-2.328), respectively. Stratified analyses further validated the robustness of this correlation. Our study establishes a nonlinear association between BT and in-hospital mortality in patients with both CHF and DM, with optimal suitable BT at 36.8°C. Further research is necessary to confirm this relationship.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"197-204"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399379","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":"Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for <i>Therapeutic Hypothermia and Temperature Management</i>.","authors":"Marianne Thoresen","doi":"10.1089/ther.2024.33245.rfs2023","DOIUrl":"https://doi.org/10.1089/ther.2024.33245.rfs2023","url":null,"abstract":"","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"14 3","pages":"129"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133832","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":"Efficacy and Safety of Therapeutic Hypothermia as an Adjuvant Therapy for Percutaneous Coronary Intervention in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis.","authors":"Ali Mir, Mohammed Faraaz Rahman, Khaled Mohamed Ragab, Ahmed Hashem Fathallah, Shaden Daloub, Nader Alwifati, Abdulrahman Ibrahim Hagrass, Anas Zakarya Nourelden, Sarah Makram Elsayed, Ibrahim Kamal, Mahmoud M Elhady, Raheel Khan","doi":"10.1089/ther.2023.0007","DOIUrl":"10.1089/ther.2023.0007","url":null,"abstract":"<p><p>The study aims to compare the use of hypothermia in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) with control. We systematically searched four electronic databases until March 2022. The inclusion criteria were any study design that compared hypothermia in patients with MI undergoing PCI with control. The risk of bias assessment of the included randomized controlled trials was conducted through Cochrane Tool, while the quality of the included cohort studies was assessed by the NIH tool. The meta-analysis was performed on RevMan. A total of 19 studies were entered. Regarding the mortality, there were nonsignificant differences between hypothermia and control (odds ratio [OR] = 1.06, 95% confidence interval [CI] 0.75 to 1.50, <i>p</i> = 0.73). There was also no significant difference between the control and hypothermia in recurrent MI (OR = 1.21, 95% CI 0.64 to 2.30, <i>p</i> = 0.56). On the other hand, the analysis showed a significant favor for hypothermia over the control infarct size (mean difference = -1.76, 95% CI -3.04 to -0.47, <i>p</i> = 0.007), but a significant favor for the control over hypothermia in the overall bleeding complications (OR = 1.88, 95% CI 1.11 to 3.18, <i>p</i> = 0.02). Compared with the control, hypothermia reduced the infarct size of the heart, but this finding was not consistent across studies. However, the control had lower rates of bleeding problems. The other outcomes, such as death and the incidence of recurrent MI, were similar between the two groups.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"152-171"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41179961","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 Association Between Hypoxic-Ischemic Encephalopathy and Thyroid Hormones.","authors":"Asli Okbay Gunes, Aydin Bozkaya","doi":"10.1089/ther.2023.0046","DOIUrl":"10.1089/ther.2023.0046","url":null,"abstract":"<p><p>We aimed to compare serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels in neonates with different hypoxic-ischemic encephalopathy (HIE) stages undergoing therapeutic hypothermia (TH), and to evaluate the TSH and fT4 levels in neonates with HIE/TH in comparison with a control group. This was a retrospective study conducted between January 2020 and December 2022. The neonates with HIE/TH constituted the study group and the neonates with transient tachypnea of the newborn (TTN) constituted the control group. The study group consisted of neonates with stage 2 and stage 3 HIE. Serum TSH and fT4 levels measured at postnatal fifth day were compared between the groups. Of the 202 (47.1%) neonates included in the study group, 144 (71.3%) had stage 2 HIE and 58 (28.7%) had stage 3 HIE. In the control group, there were 227 (52.9%) newborns. Serum TSH and fT4 levels were found to be lower in the newborns with stage 3 HIE compared with those with stage 2 HIE (<i>p</i> = 0.015, 0.002, respectively). Although the serum TSH level was higher in the newborns with HIE compared with the newborns with TTN, serum fT4 levels did not change between the groups (<i>p</i> = < 0.001, 0.14, respectively). When we made the analysis according to the reference intervals, HIE/TH was associated with higher rates of TSH elevation compared with TTN, and the difference was more pronounced in stage 2 HIE/TH (<i>p</i> < 0.001). Although stage 3 HIE/TH was significantly associated with higher rates of low fT4 compared with TTN (<i>p</i> = 0.006), this relationship was not significant between stage 2 HIE/TH and TTN. It would be reasonable to interpret thyroid function tests performed on the fifth day with caution in newborns with HIE/TH, because higher TSH and lower fT4 levels on the fifth day in this patient group may result in unnecessary repetition of tests.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"186-190"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214249","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":"Antipyretic and Anti-Inflammatory Effects of Rectal Administration of Reduning Injection in Feverish Rats Induced by Lipopolysaccharide.","authors":"Miao-Yuan Li, Qin-Yuan Guo, Juan Wang, Kun-Quan Tang, Huo-Qing Lu, Bei Wang, Lei Xiong","doi":"10.1089/ther.2023.0056","DOIUrl":"10.1089/ther.2023.0056","url":null,"abstract":"<p><p>This study aimed to explore the antipyretic and anti-inflammatory effects of rectal administration of Reduning injection in feverish rats induced by lipopolysaccharide (LPS), and observe the temperature changes and inflammatory indexes. The selected rats were randomly divided into 6 groups, with 10 rats in each group, named as normal empty group, model group, intravenous group (2 mL/kg), low-dose enema group (1 mL/kg), middle-dose enema group (2 mL/kg), and high-dose enema group (4 mL/kg). The hourly temperature variations in rats injected with LPS in the abdomen were recorded. Five hours later, blood samples from the abdominal aorta were collected to monitor immunoglobulin M (IgM), immunoglobulin A (IgA), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. At 5 hours, the fever peak induced by LPS appeared, and obvious antipyretic effects were observed; the effect was optimal in the medium dose enema group at 4 hours (<i>p</i> < 0.05); the IgM value in the enema groups, the intravenous group, and normal empty group was significantly lower than that in the model group; the IgA value in each group was higher than that in the model group, but there was no statistical significance (<i>p</i> > 0.05); values of IL-6 and TNF-α in each group were lower than those in the model group, and the difference was statistically significant except for the high-dose enema group (<i>p</i> > 0.05). Low-dose and medium-dose rectal administration of Reduning injection have inhibitory effects on IL-6, TNF-α, and IgM in feverish rats induced by LPS, but there is no obvious difference compared to intravenous administration and it could achieve an anti-inflammatory effect. There is a possibility of enhancing IgA immunity with rectal administration, but there is no obvious difference compared to intravenous administration, and rectal administration has no significant effect on mucosal immunity.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"191-196"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682584","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":"Brain Protection Effects of Mild Hypothermia Combined with Distant Ischemic Postconditioning and Thrombolysis in Patients with Acute Ischemic Stroke.","authors":"Changping Jiao, Cui Liu, Zhenhua Yang, Chunfeng Jin, Xi Chen, Jujun Xue, Ge Zhang, Chengli Pan, Jianrong Jia, Xiaojun Hou","doi":"10.1089/ther.2023.0043","DOIUrl":"10.1089/ther.2023.0043","url":null,"abstract":"<p><p>To assess the effectiveness and molecular mechanisms of mild hypothermia and remote ischemic postconditioning (RIPC) in patients with acute ischemic stroke (AIS) who have undergone thrombolysis therapy. A total of 58 AIS patients who received recombinant tissue plasmin activator (rt-PA) intravenous thrombolysis were included in this prospective study. Participants were randomly allocated to the experimental group (rt-PA intravenous thrombolysis plus mild hypothermic ice cap plus remote ischemic brain protection, <i>n</i> = 30) and the control group (rt-PA intravenous thrombolysis plus 0.9% saline, <i>n</i> = 28). The RIPC was performed for 14 consecutive days on both upper limb arteries spaced 2 minutes apart. Five cycles of ischemia-reperfusion were performed sequentially (2-2, 3-3, 4-4, 5-5, 5-0 minutes, respectively). The outcome measures of the National Institute of Health stroke scale (NIHSS) score, volume of cerebral infarction, serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1β, tumor necrosis factor α, nuclear factors kappa B (NF-κB), and NOD-1ike receptor pyrin 3 (NLRP3) were evaluated at different time points after treatment. Similarly, the 90-day modified Rankin Scale (mRS) scores were compared between the two groups. After treatment, the NIHSS score, MDA, NF-κB, and NLRP3 levels in the experimental group were significantly lower than those in the control group (<i>p</i> < 0.05). While the SOD in the experimental group was significantly higher than in the control group (<i>p</i> < 0.05), the NIHSS scores decreased within groups (all <i>p</i> < 0.05) in both experimental and control groups. The 90-day mRS score (0-2 points) in the experimental group was significantly higher than that in the control group (73.33% vs. 53.57%, <i>p</i> < 0.05) and no significant differences were observed in the safety indices between the two groups (all <i>p</i> > 0.05). Our study shows that combining mild hypothermia and RIPC has a positive effect on brain protection and can significantly reduce the oxidative stress and associated outburst of inflammatory response. The Clinical Trial Registration number is ChiCTR2300073136.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"172-178"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211346","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}