Extracorporeal venovenous cooling for induction of mild hypothermia in human-sized swine*

Hölzer, Michael; Behringer, Wilhelm; Janata, Andreas; Bayegan, Keywan; Schima, Heinrich; Deckert, Zeno; Losert, Udo; Laggner, Anton N.; Sterz, Fritz

doi:10.1097/01.ccm.0000166356.45902.a2

Cited by 38 publications

(16 citation statements)

References 31 publications

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“…Die Temperaturstabilität ist während der Behandlung für den optimalen Einsatz der therapeutischen Hypothermie von großer Bedeutung [11,17,20]. Temperaturschwankungen können neben hämo-dynamischer Instabilität [24] auch einen Anstieg des intrazerebralen Druckes zur Folge haben [25].…”

Section: Aufrechterhaltung Der Zieltemperaturunclassified

“…B. küh-lende Packungen, kaltwasser-bzw. kaltluftdurchflossene Decken und Matten, gekühlte Infusionslösungen und endovaskuläre Kühlsysteme [3,4,8,14].Der Zeitraum bis zum Erreichen der Zieltemperatur, die Stabilität der Temperatur während der Kühlbehandlung und die kontrollierte Wiedererwärmung stellen wesentliche Faktoren für den Kühl-erfolg dar [12,17,19]. In der vorliegenden Studie wird ein endovaskuläres Kühlsys-tem mit einem Oberflächenkühlsystem bezüglich dieser kühlungsrelevanten Parameter verglichen.…”

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Endovaskuläre Kühlung oder Oberflächenkühlung?

et al. 2008

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Section: Aufrechterhaltung Der Zieltemperaturunclassified

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Endovaskuläre Kühlung oder Oberflächenkühlung?

et al. 2008

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“…Furthermore, the use of TH alone or in combination with thrombolysis has been shown to produce higher survival rates with preclinical thromboembolic stroke models [14]. In such animal studies, employing a temperature range of [28][29][30][31][32][33][34] C has produced the most favorable results [8]. Although limited, there have been some promising human clinical trials showing the potential efficacy of TH around 33 C. Lower temperatures may lead to complications that override the benefit of TH [8].…”

Section: Introductionmentioning

confidence: 99%

A Head and Neck Support Device for Inducing Local Hypothermia

Gladen

Iaizzo

Bischof

et al. 2013

Journal of Medical Devices

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The present work describes the design of a device/system intended to induce local mild hypothermia by simultaneously cooling a patient's head and neck. The therapeutic goal is to lower the head and neck temperatures to 33-35 C, while leaving the core body temperature unchanged. The device works by circulating a cold fluid around the exterior of the head and neck. The head surface area is separated into five different cooling zones. Each zone has a cooling coil and can be independently controlled. The cooling coils are tightly wrapped concentric circles of tubing. This design allows for a dense packing of tubes in a limited space, while preventing crimping of the tubing and minimizing the fluid pressure head loss. The design in the neck region also has multiple tubes wrapping around the circumference of the patient's neck in a helix. Preliminary testing indicates that this approach is capable of achieving the design goal of cooling the brain tissue (at a depth of 2.5 cm from the scalp) to 35 C within 30-40 min, without any pharmacologic or circulatory manipulation. In a comparison with examples of current technology, the device has shown the potential for improved cooling capability.

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“…24 Although short-term hypothermia is nowadays considered to improve outcome in patients after resuscitation from cardiac arrest, data on prolonged hypothermia in patients with acute intracranial pathology are controversial. 21 Because severe adverse effects of mild to moderate hypothermia (ie, body core temperature 33°C to 35°C) may outweigh its beneficial effects in ICU patients with various diseases, the use of therapeutic hypothermia is still under debate. 25,26 Given this uncertainty, it seemed reasonable to study whether maintaining prophylactic normothermia may be both efficacious and safe.…”

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Prophylactic, Endovascularly Based, Long-Term Normothermia in ICU Patients With Severe Cerebrovascular Disease

Broessner

Beer

Lackner

et al. 2009

Stroke

107

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Background and Purpose— We sought to study the effectiveness and safety of endovascular cooling to maintain prophylactic normothermia in comparison with standardized, stepwise, escalating fever management to reduce fever burden in patients with severe cerebrovascular disease. Methods— This study was a prospective, randomized, controlled trial with a blinded neurologic outcome evaluation comparison between prophylactic, catheter-based normothermia (CoolGard; ie, body core temperature 36.5°C) and conventional, stepwise fever management with anti-inflammatory drugs and surface cooling. Patients admitted to 1 of the 2 neurointensive care units were eligible for study inclusion when they had a (1) spontaneous subarachnoid hemorrhage with Hunt & Hess grade between 3 and 5, (2) spontaneous intracerebral hemorrhage with a Glasgow Coma Scale score ≤10, or (3) complicated cerebral infarction requiring intensive care unit treatment with a National Institutes of Health Stroke Scale score ≥15. Results— A total of 102 patients (56 female) were enrolled during a 3.5-year period. Fifty percent had a spontaneous subarachnoid hemorrhage, 40% had a spontaneous intracerebral hemorrhage, and 10% had a complicated cerebral infarction. Overall median total fever burden during the course of treatment was 0.0°C hour and 4.3°C hours in the catheter and conventional groups, respectively ( P <0.0001). Prophylactic normothermia did not lead to an increase in the number of patients who experienced a major adverse event. No significant difference was found in mortality and neurologic long-term follow-up. Conclusions— Long-term, catheter-based, prophylactic normothermia significantly reduces fever burden in neurointensive care unit patients with severe cerebrovascular disease and is not associated with increased major adverse events.

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Extracorporeal venovenous cooling for induction of mild hypothermia in human-sized swine*

Abstract: Extracorporeal venovenous cooling was an effective and safe method to rapidly induce therapeutic mild hypothermia in human-sized swine. It seems to be promising for further application and investigation in patients.

Cited by 38 publications

References 31 publications

Endovaskuläre Kühlung oder Oberflächenkühlung?

Endovaskuläre Kühlung oder Oberflächenkühlung?

A Head and Neck Support Device for Inducing Local Hypothermia

Prophylactic, Endovascularly Based, Long-Term Normothermia in ICU Patients With Severe Cerebrovascular Disease

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