Therapeutic hypothermia and temperature management最新文献

{"title":"Heat Transfer Capabilities of Surface Cooling Systems for Inducing Therapeutic Hypothermia.","authors":"Curtis Leclerc, Morteza Talebian Nia, Gordon G Giesbrecht","doi":"10.1089/ther.2023.0003","DOIUrl":"10.1089/ther.2023.0003","url":null,"abstract":"<p><p>Therapeutic hypothermia (TH) is used to treat patients with cerebral ischemia. Body surface cooling provides a simple noninvasive method to induce TH. We compared three surface cooling systems (Arctic Sun with adhesive ArcticGel pads [AS]); Blanketrol III with two nonadhesive Maxi-Therm Lite blankets [BL]); and Blanketrol III with nonadhesive Kool Kit [KK]). We hypothesized that KK would remove more heat due to its tighter fit and increased surface area. Eight subjects (four females) were cooled with each system set to 4°C outflow temperature for 120 minutes. Heat loss, skin and esophageal temperature, and metabolic heat production were measured. Skin temperature was higher with KK (<i>p</i> = 0.002), heat loss was lower with KK in the first hour (<i>p</i> = 0.014) but not after 120 minutes. Heat production increased similarly with all systems. Core temperature decrease was greater for AS (0.57°C) than BL (0.14°C; <i>p</i> = 0.035), but not KK (0.24°C; <i>p</i> = 0.1). Each system had its own benefits and limitations. Heat transfer capability is dependent on the cooling pump unit and the design of the liquid-perfused covers. Both Arctic Sun and Blanketrol III cooling/pump units had 4°C output temperatures. However, the Blanketrol III unit had a greater flow rate and therefore more cooling power. The nonadhesive BL and KK covers were easier to apply and remove compared with the adhesive AS pads. AS had an early transient advantage in heat removal, but this effect decreased over the course of cooling, thus minimizing or eliminating any advantage during longer periods of cooling that occur during clinical TH. Clinical Trial Registration number: NCT04332224.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 3","pages":"149-158"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10177417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redistributional Hypothermia Prevention by Prewarming with Forced-Air: Exploratory, Open, Randomized, Clinical Trial of Efficacy.","authors":"Kazuhiro Shirozu,&nbsp;Keiko Nobukuni,&nbsp;Jun Maki,&nbsp;Kanako Nagamatsu,&nbsp;Ryudo Tanaka,&nbsp;Kaiki Oya,&nbsp;Kouta Funakoshi,&nbsp;Midoriko Higashi,&nbsp;Ken Yamaura","doi":"10.1089/ther.2022.0009","DOIUrl":"https://doi.org/10.1089/ther.2022.0009","url":null,"abstract":"<p><p>Avoiding redistributional hypothermia that decreases core temperature by 0.5-1.5°C within the 1st hour of surgery is difficult. The efficacy of prewarming using a forced-air warming (FAW) device with a lower-body blanket on redistribution hypothermia during epidural procedures have not been investigated. After ethics approval, 113 patients undergoing laparoscopic surgery under general anesthesia combined with epidural anesthesia were enrolled. Intervention (prewarming) group patients who were warmed from operating room entry, including during epidural anesthesia, was compared with the control group that was warmed from just before surgery started. In total, 104 patients (52, control; 52, prewarming) were analyzed. In the prewarming group, compared to the control group, the core temperature 20 minutes after anesthesia induction (36.9 ± 0.4 vs. 37.1 ± 0.4°C, <i>p</i> < 0.02) was significantly higher. The core temperature was higher in the prewarming group than in the control group until 3 hours after the surgery. In the prewarming group, compared to the control group, the core temperature-time integral below baseline till 180 minutes after surgery start (65.1 ± 64.0 vs. 8.1 ± 18.6°C/min, <i>p</i> < 0.0001) or 30 minutes after anesthesia induction (5.3 ± 6.2 vs. 2.0 ± 4.7°C/min, <i>p</i> < 0.0001) were significantly smaller. Postoperative shivering was comparable between the groups. Prewarming during epidural catheter insertion with a FAW device could safely prevent a core temperature decrease induced by redistribution or heat loss without additional preparation, effort, space, or time requirements.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"55-61"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995607","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 in Knee Arthroplasty: Systematic Review and Meta-Analysis.","authors":"Priciane Tais Krampe,&nbsp;Anna Julia Pereira Bendo,&nbsp;Marcia Izabeli Guimarães Barros,&nbsp;Gladson Ricardo Flor Bertolini,&nbsp;Márcia Rosângela Buzanello Azevedo","doi":"10.1089/ther.2022.0043","DOIUrl":"https://doi.org/10.1089/ther.2022.0043","url":null,"abstract":"<p><p>Total knee arthroplasty is performed to relieve knee pain and disability related to end-stage osteoarthritis. Cryotherapy is used as an analgesic method, reducing the intraarticular temperature. The objective of this study was to review the literature on the efficacy of cryotherapy in knee arthroplasty. A total of 700 articles were found in databases according to the search criteria for each database and the included descriptors (EndNote Web). After exclusion of duplicate articles, automatically and manually, Phase 1 was performed-reading of titles and abstracts of 375 articles according to the eligibility criteria by two blinded reviewers using the Rayyan QCRI (Qatar Computing Research Institute) program, conflicts were resolved in consensus between the 2 reviewers. Thus, 21 articles were selected for Phase 2-reading in full, leaving 5 articles for this review. The Cochrane instrument Rob 2 was used to assess the quality of bias of the selected studies, and RevMan 5.4.1 was used for meta-analysis. The age of study participants ranged from 51 to 74 years. The sample size ranged from 37 to 389 subjects, with a total of 648 subjects. The risk of bias was almost entirely high and moderate for all endpoints: pain, range of motion (ROM), and function. There was a decrease in pain level and as secondary endpoints ROM and functionality, there were divergences between studies. It can be concluded that although cryotherapy is indicated to reduce pain in the postoperative period of knee arthroplasty, studies have many methodological biases and the meta-analysis performed could not confirm the effects; therefore, more primary studies are needed to better understand the effects.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"45-54"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573462","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":"Re: \"Effect of Forced-Air Warming Blanket on Perioperative Hypothermia in Elderly Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer\" by Zhang et al.","authors":"Zhongpeng Sun,&nbsp;Dong Yang","doi":"10.1089/ther.2022.0058","DOIUrl":"https://doi.org/10.1089/ther.2022.0058","url":null,"abstract":"","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"86"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039206","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":"A Case of Sudden Cardiac Arrest After Brainstem Infarction.","authors":"Takahiro Suzuki,&nbsp;Toru Hifumi,&nbsp;Masahiro Goto,&nbsp;Shutaro Isokawa,&nbsp;Norio Otani","doi":"10.1089/ther.2022.0064","DOIUrl":"https://doi.org/10.1089/ther.2022.0064","url":null,"abstract":"<p><p>Research on the causes of sudden cardiac arrest (CA) after ischemic stroke, especially disruption of the autonomic nervous system's central control, has recently focused more on the widespread cortical and subcortical network than on autonomic circuits at the spinal and brainstem level. However, no clinical case of sudden CA requiring cardiopulmonary resuscitation (CPR) after brainstem infarction has been reported. We report a case of a 78-year-old woman who died suddenly from a brainstem infarction. Her husband heard a falling sound and found her unresponsive and lying with agonal breathing. The initial cardiac rhythm was pulseless electrical activity confirmed by emergency medical technicians. Recovery of spontaneous circulation was achieved after CPR. Basilar artery occlusion was shown on computed tomography, but no other findings that could have caused CA were found. Targeted temperature management was initiated, but she died on hospital day 22. Brainstem infarction may cause sudden CA; therefore, definitive treatment may achieve better outcomes.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"87-89"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9942208","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":"Immediate Cooling and Early Decompression for the Treatment of Cervical Spinal Cord Injury: A Safety and Feasibility Study.","authors":"Peter Batchelor,&nbsp;Stephen Bernard,&nbsp;Dashiell Gantner,&nbsp;Andrew Udy,&nbsp;Jasmin Board,&nbsp;Mark Fitzgerald,&nbsp;Peta Skeers,&nbsp;Camila Battistuzzo,&nbsp;Mick Stephenson,&nbsp;Karen Smith,&nbsp;Andrew Nunn","doi":"10.1089/ther.2022.0046","DOIUrl":"https://doi.org/10.1089/ther.2022.0046","url":null,"abstract":"<p><p>Cervical spinal cord injury (SCI) usually results in severe, long-term disability. Early therapeutic hypothermia (33-34°C) has been used to improve outcomes in preclinical studies, but previous clinical studies have commenced cooling after arrival at hospital. The objective of the study is to determine the feasibility and safety of early therapeutic hypothermia initiated by paramedics and maintained for up to 24 hours in hospital in patients with SCI. This is a pilot clinical study. The study was undertaken at Ambulance Victoria and The Alfred Hospital, Victoria, Australia. A total of 17 consecutive patients with suspected acute traumatic cervical SCI were enrolled. Patients with suspected cervical SCI were administered a bolus (up to 20 mL/kg) intravenous (IV) cold (4°C) normal saline in the prehospital phase of care. After hospital admission and spinal imaging, further cooling used IV catheter temperature control or surface cooling. Major complications and long-term outcomes were compared with historical controls admitted to the same center before the study. A decrease in core temperature of 1.1°C was achieved during prehospital care and the target temperature was achieved in 6 hours with mechanical temperature management devices in the hospital. There were no major safety concerns. Patients with motor complete SCI who underwent early decompressive surgery had a favorable rate of partial spinal cord recovery compared with historical controls. Therapeutic hypothermia induced using bolus, large-volume, ice-cold saline prehospital and maintained for 24 hours using mechanical devices appears to be feasible and safe in patients with SCI. Larger trials need to be undertaken to determine whether prehospital cooling combined with early decompressive surgery improves outcomes in patients with complete cervical SCI. Australian and New Zealand Clinical Trials Registry (ACTRN12616001086459).</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"77-85"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623835","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":"Is Selective Head Cooling Combined with Whole-Body Cooling the Most Effective Hypothermia Method for Neonatal Hypoxic-Ischemic Encephalopathy?","authors":"Yalcin Celik,&nbsp;Anıl Özgür,&nbsp;Mehmet Ali Sungur,&nbsp;Nazım Yıldırım,&nbsp;Selçuk Teke","doi":"10.1089/ther.2022.0021","DOIUrl":"https://doi.org/10.1089/ther.2022.0021","url":null,"abstract":"<p><p>This study aimed to compare combined hypothermia (CH) to the 2 classical therapeutic hypothermia (TH) methods selective head cooling (SHC) and whole-body cooling (WBC). This retrospective cohort study included neonates who underwent CH, SHC, and WBC between 2012 and 2020. Mean rectal temperature was maintained at 33.5 ± 0.5°C by cooling the head and the body in the CH group, at 34.5 ± 0.5°C by cooling the head in the SHC group, and at 33.5 ± 0.5°C by cooling the body in the WBC group. The groups were compared in terms of side effects, magnetic resonance imaging (MRI) scores, and status at discharge. The study included 60 neonates in the CH group, 112 in the WBC group, and 27 in the SHC group. There was no significant difference in side effects between the groups (<i>p</i> > 0.05). There was no significant difference in brain MRI scores between the groups (<i>p</i> > 0.05); however, gray matter, white matter, and total MRI scores in the CH group were lower than in the WBC group. Duration of hospitalization was shorter in the CH group than in the other two groups (<i>p</i> = 0.022). CH was not associated with more side effects than the two classical TH methods. In addition, some of these findings suggest that CH might result in better clinical outcome than the two classical TH methods.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"70-76"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925279","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":"A Case Series of Clinical Limitations to the Clinical Course of Neurogenic Fever.","authors":"Jessica R Chorostecki,&nbsp;Nathan J Schneider,&nbsp;Sonja E Stutzman,&nbsp;DaiWai M Olson","doi":"10.1089/ther.2022.0031","DOIUrl":"https://doi.org/10.1089/ther.2022.0031","url":null,"abstract":"<p><p>Nurses play a vital role in the care of neurocritical patients. Fever is a common and dangerous occurrence, and there is a substantial lack of consistency in how to maintain normothermia in these patients. We present five cases in which patients were confirmed to have neurogenic fever (NF) and the documented interventions. In all five cases, temperature and interventions were not documented consistently, making it difficult to assess how nurses acted to avoid hyperthermia in these patients. Additional research is needed to determine interventions, processes, procedures, and documentation of NF in neurocritical patients.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"62-65"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677831","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":"A Novel Device for Intraoperative Hypothermia Prevention in Patients with Lower Abdominal Surgery: A Prospective Randomized Single-Center Study.","authors":"Chun-Juan Shi,&nbsp;Bao-Ying Zhong","doi":"10.1089/ther.2022.0017","DOIUrl":"https://doi.org/10.1089/ther.2022.0017","url":null,"abstract":"<p><p>This study aims to explore the value of lithotomy position thermal sleeve application during lower abdominal surgery in patients with hypothermia. A total of 100 patients who underwent urinary, gastrointestinal, or gynecological operations were included in this study. The patients were randomly divided into two groups: the test group (<i>n</i> = 50) and the control group (<i>n</i> = 50). In the control group, the environment, fluid, patient upper abdomen, and pasted 3 L stone-cut pants were heated. In the test group, the lithotomy position surgical warmer was used based on environment, fluid, and upper abdomen warming. The various indicators present in the two groups were compared and analyzed using the Statistical Package for Social Sciences 19.0. Before the operation, the body temperature was 36.73°C ± 0.28°C in the test group and 36.74°C ± 0.29°C in the control group; the difference between the two groups was not statistically significant (<i>p</i> > 0.05). In the test group, the entry temperature was 36.83°C ± 0.04°C; after 2 hours of operation, it became 37.21°C ± 0.03°C. There were no significant changes in body temperature after 4 hours of operation, basic body temperature was maintained (36.80°C ± 0.02°C). In the control group, the entry temperature was 36.54°C ± 0.05°C; however, it became 35.94°C ± 0.07°C after 2 hours of operation, making the patient prone to developing hypothermia. The differences between the two groups were statistically significant (<i>p</i> < 0.05). In patients undergoing urinary, anorectal, or gynecological operations, the use of a warming intervention during surgery in the lithotomy position can effectively stabilize body temperature and reduce the occurrence of postoperative shivering. ClinicalTrials.gov ID: ChiCTR2100046522.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 2","pages":"66-69"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9941701","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":"Re: \"Watch Out for Drug-Induced Coma and Burst Suppression Pattern in Infants and Children Mimicking Severe Neurological Disease\" by Falsaperla et al.","authors":"Nora Bruns","doi":"10.1089/ther.2022.0052","DOIUrl":"https://doi.org/10.1089/ther.2022.0052","url":null,"abstract":"","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"13 1","pages":"42-43"},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9142850","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}