Mild hypothermia combined with dexmedetomidine reduced brain, lung, and kidney damage in experimental acute focal ischemic stroke

Battaglini, Denise; Silva, Adriana Lopes da; Felix, Nathane Santanna; Rodrigues, Gisele C.; Antunes, Mariana A.; Rocha, Nazareth N.; Capelozzi, Vera Luíza; Morales, Marcelo M.; Cruz, Fernanda Ferreira; Robba, Chiara; Silva, Pedro L.; Pelosi, Paolo; Rocco, Patrícia Rieken Macêdo

doi:10.1186/s40635-022-00481-4

Cited by 3 publications

(1 citation statement)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, systemic hypothermia may offer additional benefits over selective brain/penumbral cooling because post-stroke brain inflammation has been linked to systemic inflammation and multiorgan injury. 33 , 34 ICTuS-2 administered 2 liters of 4 °C normal saline followed by 24 hours of cooling via a femoral intravenous cooling catheter and 12 hours of rewarming. 1 EuroHYP-1 used a 20 mL/kg intravenous infusion of 4 °C normal saline over 30–60 minutes followed by surface or intravenous cooling for 24 hours and passive rewarming.…”

Section: Discussionmentioning

confidence: 99%

Penumbral cooling in ischemic stroke with intraarterial, intravenous or active conductive head cooling: A thermal modeling study

Diprose,

Rao,

Ghate

et al. 2023

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

In ischemic stroke, selectively cooling the ischemic penumbra might lead to neuroprotection while avoiding systemic complications. Because penumbral tissue has reduced cerebral blood flow and in vivo brain temperature measurement remains challenging, the effect of different methods of therapeutic hypothermia on penumbral temperature are unknown. We used the COMSOL Multiphysics® software to model a range of cases of therapeutic hypothermia in ischemic stroke. Four ischemic stroke models were developed with ischemic core and/or penumbra volumes between 33–300 mL. Four experiments were performed on each model, including no cooling, and intraarterial, intravenous, and active conductive head cooling. The steady-state temperature of the non-ischemic brain, ischemic penumbra, and ischemic core without cooling was 37.3 °C, 37.5–37.8 °C, and 38.9–39.4 °C respectively. Intraarterial, intravenous and active conductive head cooling reduced non-ischemic brain temperature by 4.3 °C, 2.1 °C, and 0.7–0.8 °C respectively. Intraarterial, intravenous and head cooling reduced the temperature of the ischemic penumbra by 3.9–4.3 °C, 1.9–2.1 °C, and 1.2–3.4 °C respectively. Active conductive head cooling was the only method to selectively reduce penumbral temperature. Clinical studies that measure brain temperature in ischemic stroke patients undergoing therapeutic hypothermia are required to validate these hypothesis-generating findings.

show abstract

Section: Discussionmentioning

confidence: 99%