Is Moderate-induced Hypothermia (≤33°C) of Clinical Value after Out-of-hospital Cardiac Arrest – Systematic Review and Meta-analysis of 10 Randomized Clinical Trials DOI
Haifa Algethamy,

Wadeeah Bahaziq

Saudi Critical Care Journal, Journal Year: 2023, Volume and Issue: 7(4), P. 86 - 97

Published: Oct. 1, 2023

Abstract Background: Uncertainty remains regarding potential benefits of induced hypothermia (IHT) after out-of-hospital cardiac arrest (OHCA). Spanning 12 meta-analyses randomized clinical trials (RCTs) published since 2020, conclusions have ranged from IHT improving both survival and neurological outcomes, to neither, increasing patient risk. In this meta-analysis, we compare 31-33°C against no 34-36°C while trying overcome some the shortfalls prior meta-analyses. Methods: After an extensive search four scientific databases, steps were taken select RCTs at low risk bias, using Cochrane Collaboration bias tool, otherwise appropriate for question hand examining issues concern with Meta-analysis was performed patients shockable non-shockable rhythms together and, as feasible, separately, generating odds ratios (OR) each RCT separately compiled mortality outcomes. Result: Ten encompassing 2129 31-33 2123 rhythm-matched controls analyzed. Overall, benefit either or outcome identified. However, three six comparing unveiled statistically-significant improvements in compiling data these studies just failed identify a significant (OR=1.16, 0.98-1.36; p=0.077). Among 496 whom rhythm-specific outcomes reported, good achieved 57.0% 54.9% versus 20.1% 8.6% among those rhythms, respectively. Conclusion: evaluating moderate use OHCA remain necessary.

Language: Английский

Smart textiles for chronic disease management: Advancements, applications, and future prospects DOI
Ziying Wang, Xinqi Zhao, Kai Yan

et al.

Materials Science and Engineering R Reports, Journal Year: 2025, Volume and Issue: 164, P. 100987 - 100987

Published: April 2, 2025

Language: Английский

Citations

1
Targeted Temperature Management At 33 Versus 36 Degrees After Out-Of-Hospital Cardiac Arrest: A Follow-Up Study DOI Creative Commons

Robert Doerning,

Kyle Danielson,

Jane Hall

et al.

Resuscitation Plus, Journal Year: 2025, Volume and Issue: 22, P. 100921 - 100921

Published: March 1, 2025

Targeted temperature management (TTM) is commonly used in the setting of out-of-hospital cardiac arrest (OHCA) to improve survival and functional outcomes. However, real-world evidence effects optimal are limited. To help address this, we examined associations between TTM neurologically-intact after non-traumatic OHCA across changing institutional goals. We performed a single-site, retrospective, cohort study adults with who arrived comatose emergency department received from 2010 2020. Primary exposure was goal temperature. Institutional changed 33 °C (TTM33-1) 36 (TTM36) 2014 back (TTM33-2) 2017. The primary outcome at discharge, defined as Cerebral Performance Category score 1 or 2. Secondary outcomes included hospital discharge care processes. Multivariable logistic regression analysis evaluated association neurological outcome. Of 1,469 OCHA patients meeting inclusion criteria, 800 (54%) TTM. initiated more frequently during TTM33-1 (60%) than TTM36 (52%) TTM33-2 (52%). After adjustment for demographic characteristics, there no significant survival, versus (adjusted odds ratio 1.10, 95% confidence interval 0.76, 1.60). not significantly associated adult department.

Language: Английский

Citations

0
Conflicting guidelines: a commentary on the recent European Society for Emergency Medicine and European Society of Anaesthesiology and Intensive Care guidelines on temperature control after cardiac arrest DOI
Lars W. Andersen, Mathias J. Holmberg, Jerry P. Nolan

et al.

European Journal of Anaesthesiology, Journal Year: 2024, Volume and Issue: 41(7), P. 468 - 472

Published: June 7, 2024

Language: Английский

Citations

2
Optimizing brain protection after cardiac arrest: advanced strategies and best practices DOI

Ida Giorgia Iavarone,

Katia Donadello, Gianmaria Cammarota

et al.

Interface Focus, Journal Year: 2024, Volume and Issue: 14(6)

Published: Dec. 6, 2024

Cardiac arrest (CA) is associated with high incidence and mortality rates. Among patients who survive the acute phase, brain injury stands out as a primary cause of death or disability. Effective intensive care management, including targeted temperature seizure treatment maintenance normal physiological parameters, plays crucial role in improving survival neurological outcomes. Current guidelines advocate for neuroprotective strategies to mitigate secondary following CA, although certain treatments remain subjects debate. Clinical examination neuroimaging studies, both invasive non-invasive neuromonitoring methods serum biomarkers are valuable tools predicting outcomes comatose resuscitated patients. Neuromonitoring, particular, provides vital insights identifying complications, personalizing approaches forecasting prognosis post-CA. In this review, we offer an overview advanced best practices aimed at optimizing protection after CA.

Language: Английский

Citations

2
Can Biomarkers Correctly Predict Ventilator-associated Pneumonia in Patients Treated With Targeted Temperature Management After Cardiac Arrest? An Exploratory Study of the Multicenter Randomized Antibiotic (ANTHARTIC) Study DOI Creative Commons
Nicolas Deye, Amélie Le Gouge, Bruno François

et al.

Critical Care Explorations, Journal Year: 2024, Volume and Issue: 6(7), P. e1104 - e1104

Published: July 1, 2024

IMPORTANCE: Ventilator-associated pneumonia (VAP) frequently occurs in patients with cardiac arrest. Diagnosis of VAP after arrest remains challenging, while the use current biomarkers such as C-reactive protein (CRP) or procalcitonin (PCT) is debated. OBJECTIVES: To evaluate biomarkers’ impact helping diagnosis DESIGN, SETTING, AND PARTICIPANTS: This a prospective ancillary study randomized, multicenter, double-blind placebo-controlled ANtibiotherapy during Therapeutic HypothermiA to pRevenT Infectious Complications (ANTHARTIC) trial evaluating antibiotic prophylaxis prevent out-of-hospital secondary shockable rhythm and treated therapeutic hypothermia. An adjudication committee blindly evaluated according predefined clinical, radiologic, microbiological criteria. All available biomarker(s), sample(s), consent approval were included. MAIN OUTCOMES MEASURES: The main endpoint was ability correctly diagnose predict within 48 hours sampling. combination two discriminating VAP. Blood samples collected at baseline on day 3. Routine exploratory panel inflammatory measurements performed. Analyses adjusted randomization group. RESULTS: Among 161 ANTHARTIC biological ( n = 33) had higher body mass index Acute Physiology Chronic Health Evaluation II score, more unwitnessed arrest, catecholamines, experienced prolonged hypothermia duration than without 121). In univariate analyses, significantly associated showing an area under curve (AUC) greater 0.70 CRP (AUC 0.76), interleukin (IL) 17A 17C (IL17C) (0.74), macrophage colony-stimulating factor 1 (0.73), PCT (0.72), vascular endothelial growth A (VEGF-A) (0.71). Multivariate analysis combining novel revealed several pairs p value less 0.001 odds ratio 1: VEGF-A + IL12 subunit beta (IL12B), Fms-related tyrosine kinase 3 ligands (Flt3L) C–C chemokine 20 (CCL20), Flt3L IL17A, IL6, STAM-binding (STAMBP) CCL20, STAMBP CCL20 4EBP1, caspase-8 (CASP8), IL6 CASP8. Best AUCs observed for (0.79), (0.78), IL17C. CONCLUSIONS RELEVANCE: Our shows that specific biomarkers, especially combined could help better early occurrence patients.

Language: Английский

Citations

1
Hypothermia to 33 °C Following Cardiac Arrest DOI
William E. Spears, David M. Greer

JAMA Neurology, Journal Year: 2023, Volume and Issue: 81(2), P. 115 - 115

Published: Dec. 18, 2023

Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Journals Network Open Cardiology Dermatology Health Forum Internal Medicine Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) JN Learning / CMESubscribeJobsInstitutions LibrariansReprints Permissions Terms Use Privacy Accessibility Statement 2024 American Medical Association. All Rights Reserved Search Archive Input Term Sign In Individual inCreate an Account Access through institution Purchase Options: Buy this article Rent Subscribe the journal

Language: Английский

Citations

2
Therapeutic hypothermia is not dead, but hibernating! DOI Creative Commons

Robert J. Freedman,

Robert B. Schock, W. Frank Peacock

et al.

Clinical and Experimental Emergency Medicine, Journal Year: 2024, Volume and Issue: 11(3), P. 238 - 242

Published: Sept. 30, 2024

Language: Английский

Citations

0
A review on targeted temperature management for cardiac arrest and traumatic brain injury DOI Creative Commons

Hiroshi Ito,

Sanae Hosomi,

Takeshi Nishida

et al.

Frontiers in Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: Oct. 31, 2024

Therapeutic hypothermia inhibits organ damage by suppressing metabolism, which makes it a therapy of choice for treating various diseases. Specifically, is often used to treat conditions involving central nervous system disorders where expected positively impact functional prognosis. Although keeping the body temperature at hypothermic level has been conventionally used, how manage correctly remains topic debate. Recently, concept management proposed improve quality control and avoid hyperthermia. This review focuses on effect in practice clinical situations.

Language: Английский

Citations

0
The value of hypothermia as a neuroprotective and antiepileptic strategy in patients with status epilepticus: an update of the literature DOI
Stéphane Legriel,

Candice Fontaine,

Gwenaëlle Jacq

et al.

Expert Review of Neurotherapeutics, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 10

Published: Nov. 24, 2024

Status epilepticus represents a significant neurological emergency, with high morbidity and mortality rates. In addition to standard care, the identification of adjuvant strategies is essential improve outcome.

Language: Английский

Citations

0
Therapeutic Hypothermia for ST-Elevation Myocardial Infarction: A Systematic Review, Pairwise, and Network Meta-Analysis DOI
Mohamed Gaber, Ahmed Mazen Amin, Yehya Khlidj

et al.

Cardiology in Review, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 31, 2024

There is a need to examine the evidence of therapeutic hypothermia (TH) safety and efficacy during management ST-elevation myocardial infarction. We therefore conducted systematic review meta-analysis synthesizing from randomized controlled trials obtained PubMed, Cochrane, Scopus, Web Science inception July 2024. reported dichotomous outcomes using risk ratio (RR) continuous mean difference (MD) with 95% confidence interval (CI). This study was registered CRD42024586329 on International Prospective Register Systematic Reviews. Ten 806 patients were included. no significant between both groups in major adverse cardiac event (RR: 1.50, CI: 0.71–3.15, P = 0.29), microvascular obstruction (MD: 0.12, −0.04 0.29, 0.15), infarct size −0.11, −1.65 1.43, 0.89). TH significantly associated longer door-to-balloon time 12.60, 6.75 18.46, < 0.01), increased incidence infection 3.30, 1.31 8.29, uncontrolled shivering 5.78, 1.60 20.94, 0.01). The available does not support benefit for reducing burden infarction nor lowering severity

Language: Английский

Citations

0