Intranasal perfluorochemical spray for preferential brain cooling in sheep.

Abstract:

INTRODUCTION:Hypothermic brain protection has been linked to how rapidly cooling is initiated and how quickly and uniformly the therapeutic hypothermic zone (THZ) is reached. The nasopharyngeal (NP) approach is uniquely suited for preferential brain cooling due to anatomic proximity to the cerebral circulation, cavernous sinus, and carotid arteries. This study explores a novel NP cooling approach employing evaporative characteristics of aerosolized perfluorochemical (PFC). METHODS:Anesthetized, normotensive sheep (n = 30) were instrumented with temperature probes and vascular catheters, then randomized to NP approach (NP-PFC: PFC spray device; n = 24) or whole body surface (WBS: n = 6) cooling. Regional temperatures, vital signs, and blood chemistries were assessed serially. Two animals were exposed to double PFC flow rates and PFC was measured in blood during NP-PFC cooling to assess PFC uptake and elimination. Cooling rates were evaluated (ANOVA) as a function of method (NP-PFC versus WBS) and time to reach the brain THZ (i.e., < or =-3.5 degrees C below baseline). RESULTS:Independent of region, brain cooling was faster during NP-PFC versus WBS (P < 0.001). During NP-PFC, brain > vascular > rectal cooling rates (P < 0.001), brain to systemic temperature gradients were maintained, the brain THZ was reached within 15 min, and the NP epithelial surface appeared histologically intact. During WBS, brain versus systemic cooling rates were not significantly different and the brain THZ could not be reached within 2 h. CONCLUSIONS:The NP-PFC procedure more rapidly induced preferential brain cooling as compared to WBC without adverse effects.

journal_name

Neurocrit Care

journal_title

Neurocritical care

authors

Wolfson MR,Malone DJ,Wu J,Hoffman J,Rozenberg A,Shaffer TH,Barbut D

doi

10.1007/s12028-008-9064-0

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

437-47

issue

3

eissn

1541-6933

issn

1556-0961

journal_volume

8

pub_type

杂志文章
  • Hyperbaric Oxygen Protects Against Cerebral Damage in Permanent Middle Cerebral Artery Occlusion Rats and Inhibits Autophagy Activity.

    abstract:BACKGROUND:To investigate the effects of hyperbaric oxygen (HBO) on brain damage and autophagy levels in a rat model of middle cerebral artery occlusion. METHODS:Neurologic injury and infarcted areas were evaluated according to the modified neurological severity score and 2,3,5-triphenyltetrazolium chloride staining. ...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-018-0577-x

    authors: Lu K,Wang H,Ge X,Liu Q,Chen M,Shen Y,Liu X,Pan S

    更新日期:2019-02-01 00:00:00

  • Terson's syndrome.

    abstract:BACKGROUND:Terson's syndrome is intraocular hemorrhage (IOH) subsequent to subarachnoid hemorrhage (SAH). Its presence is associated with higher mortality in SAH. We report a case of Terson's syndrome and review the literature. CASE REPORT:A 71-year-old Caucasian gentleman collapsed and became comatose. Past medical h...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-011-9555-2

    authors: Hassan A,Lanzino G,Wijdicks EF,Rabinstein AA,Flemming KD

    更新日期:2011-12-01 00:00:00

  • An unsuccessful trial of immunomodulatory therapy in delayed posthypoxic demyelination.

    abstract:INTRODUCTION:Delayed posthypoxic demyelination may rarely complicate an episode of severe hypoxia, with or without exposure to carbon monoxide. Following recovery from initial coma, progressive neurologic deterioration ensues with outcomes ranging from death to full recovery. Delayed posthypoxic demyelination is hypoth...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-007-0044-6

    authors: Khot S,Walker M,Lacy JM,Oakes P,Longstreth WT Jr

    更新日期:2007-01-01 00:00:00

  • Electroencephalography in survivors of cardiac arrest: comparing pre- and post-therapeutic hypothermia eras.

    abstract::Electroencephalography in the setting of hypothermia and anoxia has been studied in humans since the 1950s. Specific patterns after cardiac arrest have been associated with prognosis since the 1960s, with several prognostic rating scales developed in the second half of the twentieth century. In 2002, two pivotal clini...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-014-0018-4

    authors: Crepeau AZ,Britton JW,Fugate JE,Rabinstein AA,Wijdicks EF

    更新日期:2015-02-01 00:00:00

  • Osmotherapy: use among neurointensivists.

    abstract:BACKGROUND:Cerebral edema and raised intracranial pressure are common problems in neurological intensive care. Osmotherapy, typically using mannitol or hypertonic saline (HTS), has become one of the first-line interventions. However, the literature on the use of these agents is heterogeneous and lacking in class I stud...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-010-9477-4

    authors: Hays AN,Lazaridis C,Neyens R,Nicholas J,Gay S,Chalela JA

    更新日期:2011-04-01 00:00:00

  • Approach to neuromuscular disorders in the intensive care unit.

    abstract::Neuromuscular disorders increasingly are recognized as a complication in patients in the intensive care unit (ICU) and represent a common cause of prolonged ventilator dependency. The distinct syndromes of critical illness myopathy, prolonged neuromuscular blockade, and critical illness polyneuropathy (CIP) may arise ...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1385/NCC:3:3:195

    authors: Gorson KC

    更新日期:2005-01-01 00:00:00

  • Bilateral internal carotid artery occlusions resulting in near total acute brain infraction.

    abstract:INTRODUCTION:Acute bilateral acute carotid arteries occlusion is a very rare condition. We describe a patient with initial right middle cerebral artery syndrome who developed coma and quadriplegia 1 h after thrombolysis with intravenous tPA and was found to have bilateral cervical internal carotid artery occlusion. ...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-007-0076-y

    authors: Zubkov AY,Klassen BT,Burnett MS,Rabinstein AA

    更新日期:2007-01-01 00:00:00

  • Routine management of volume status after aneurysmal subarachnoid hemorrhage.

    abstract::Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarac...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-011-9593-9

    authors: Wolf S,Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage.

    更新日期:2011-09-01 00:00:00

  • Cefepime-induced nonconvulsive status epilepticus: case report and review.

    abstract:INTRODUCTION:A case of cefepime-induced nonconvulsive status epilepticus in a 15-year-old child with end stage renal disease on hemodialysis is reported. Clinical symptoms and EEG dramatically improved 48 h after discontinuation of cefepime. METHODS:Twenty-five cases of nonconvulsive status epilepticus associated with...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-008-9166-8

    authors: Thabet F,Al Maghrabi M,Al Barraq A,Tabarki B

    更新日期:2009-01-01 00:00:00

  • Comparison of Three Point-of-Care Ultrasound Views and MRI Measurements for Optic Nerve Sheath Diameter: A Prospective Validity Study.

    abstract:INTRODUCTION:Point-of-care ultrasound of the optic nerve sheath diameter (ONSD) to diagnose increased intracranial pressure (ICP) is of great interest in various clinical scenarios. Yet, the lack of examination standardization has made clinical utility difficult. We compare three ultrasound ocular plane views (inferior...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-019-00881-7

    authors: Raval R,Shen J,Lau D,Ferguson N,Kelly T,Daniels J,Dorotta I,Ramsingh D

    更新日期:2020-08-01 00:00:00

  • Impact of Sleep Deprivation in the Neurological Intensive Care Unit: A Narrative Review.

    abstract::Sleep is fundamental for everyday functioning, yet it is often negatively impacted in critically ill patients by the intensive care setting. With a focus on the neurological intensive care unit (NeuroICU), this narrative review summarizes methods of measuring sleep and addresses common causes of sleep disturbance in t...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-019-00795-4

    authors: Chang VA,Owens RL,LaBuzetta JN

    更新日期:2020-04-01 00:00:00

  • Pharmacology and clinical use of recombinant activated factor seven in neurosciences.

    abstract::Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordisc, Danemark) has been approved for the treatment of patients with hemophilia with inhibitors, further indications, at least in some countries, include the treatment of factor VII deficiency and Glanzmann thrombasthenia refractory to conventional therapy. A...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-007-0006-z

    authors: Hartmann M,Sucker C

    更新日期:2007-01-01 00:00:00

  • A device for fast mechanical clot retrieval from intracranial arteries (Phenox clot retriever).

    abstract:INTRODUCTION:To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use. METHODS:A device with oriented microfilaments was constructed that consists of a core wires compound surrounded by a dense palisade of perpendicular-oriented stiff polya...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1385/NCC:5:2:134

    authors: Henkes H,Reinartz J,Lowens S,Miloslavski E,Roth C,Reith W,Kühne D

    更新日期:2006-01-01 00:00:00

  • Hypertonic Sodium Lactate to Alleviate Functional Deficits Following Diffuse Traumatic Brain Injury: An Osmotic or a Lactate-Related Effect?

    abstract:BACKGROUND:There has been growing interest in the use of hypertonic sodium lactate (HSL) solution following traumatic brain injury (TBI) in humans. However, little is known about the effects of HSL on functional deficits with respect to the hyperosmotic nature of HSL. METHODS:We have compared the effects of HSL soluti...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-020-01090-3

    authors: Crespy T,Durost M,Fricault P,Lemasson B,Bouzat P,Barbier EL,Payen JF

    更新日期:2020-09-09 00:00:00

  • Attitudes of Nurses Toward Disability and Treatment in Space-Occupying Middle Cerebral Artery Stroke.

    abstract:BACKGROUND:Attitudes toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in space-occupying middle cerebral artery stroke (SOS). The attitudes of nurses deserve strong attention, because of their close interaction with patients during ...

    journal_title:Neurocritical care

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s12028-018-0586-9

    authors: Neugebauer H,Malakou F,Uttner I,Köpke M,Jüttler E,IGNITE Study Group (Initiative of German NeuroIntensive Trial Engagement).

    更新日期:2019-02-01 00:00:00

  • Continuous brain tissue oxygenation monitoring in the management of pediatric stroke.

    abstract:BACKGROUND:Direct invasive monitoring of brain tissue oxygenation (PbtO(2)) has been routinely utilized to predict cerebral ischemia and to prevent secondary injury in patients with traumatic brain injury (TBI) and vasospasm secondary to subarachnoid hemorrhage (SAH). The safety and utility of these devices in the pedi...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-011-9531-x

    authors: Allen BB,Hoffman CE,Traube CS,Weinstein SL,Greenfield JP

    更新日期:2011-12-01 00:00:00

  • Intrathecal saline infusion: an emergency procedure in a patient with spontaneous intracranial hypotension.

    abstract:BACKGROUND:Spontaneous intracranial hypotension (SIH) is a neurologic condition with the prototypical symptom of orthostatic headache. We report a dramatic case of SIH with life-threatening bilateral hygroma and uncal herniation. METHODS:Case report. RESULTS:A 44-year-old male patient presenting with orthostatic head...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-012-9783-0

    authors: Sass C,Kosinski C,Schmidt P,Mull M,Schulz J,Schiefer J

    更新日期:2013-08-01 00:00:00

  • Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins.

    abstract:INTRODUCTION:Over-the-counter herbal and alternative medicines are classified as dietary supplements and, unlike drugs, are not rigorously regulated by the United States Food and Drug Administration. Their potential adverse effects are often poorly characterized. METHOD:Red clover, dong quai, and Siberian ginseng are ...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-007-0075-z

    authors: Friedman JA,Taylor SA,McDermott W,Alikhani P

    更新日期:2007-01-01 00:00:00

  • Statins in the management of patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

    abstract:BACKGROUND:Delayed ischemic neurological deficits (DINDs) contribute to morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Based on promising preliminary reports, some clinicians routinely administer statins to prevent DINDs. METHODS:Without language restriction, we searched MEDLINE, EMBASE, t...

    journal_title:Neurocritical care

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s12028-009-9306-9

    authors: Kramer AH,Fletcher JJ

    更新日期:2010-04-01 00:00:00

  • Emergency neurological life support: subarachnoid hemorrhage.

    abstract::Subarachnoid hemorrhage (SAH) is a neurological emergency because it may lead to sudden neurological decline and death and, depending on the cause, has treatment options that can return a patient to normal. Because there are interventions that can be life-saving in the first hour of onset, SAH was chosen as an Emergen...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-012-9761-6

    authors: Edlow JA,Samuels O,Smith WS,Weingart SD

    更新日期:2012-09-01 00:00:00

  • Early Mobilization in the Neuro-ICU: How Far Can We Go?

    abstract::Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a uniq...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-016-0338-7

    authors: Olkowski BF,Shah SO

    更新日期:2017-08-01 00:00:00

  • Inter-observer agreement on the diagnosis of neurocardiogenic injury following aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND:Neurocardiogenic injury results from increased sympathetic nervous system activation following acute brain injury. No diagnostic criteria for neurocardiogenic injury exist, and agreement has not been tested. We investigated the agreement by neurointensivists for the presence of neurocardiogenic injury on rou...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-013-9941-z

    authors: Fletcher JJ,Meurer W,Dunne M,Rajajee V,Jacobs TL,Sheehan KM,Nathan B,Kade AM

    更新日期:2014-04-01 00:00:00

  • Safety of imipenem/cilastatin in neurocritical care patients.

    abstract:BACKGROUND:Infection in the intensive care unit (ICU) empirically requires broad-spectrum antibiotics. Imipenem/cilastatin, often reserved for more serious hospital-acquired infections, is thought to be associated with a higher risk of seizures than other penicillins and carbapenems. We sought to evaluate the safety of...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-008-9170-z

    authors: Hoffman J,Trimble J,Brophy GM

    更新日期:2009-01-01 00:00:00

  • Intracranial Hypertension After Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-analysis of Prevalence and Mortality Rate.

    abstract::The objective of this study was to determine the prevalence of intracranial hypertension (IHT) and the associated mortality rate in patients who suffered from primary intracerebral hemorrhage (ICH). A secondary objective was to assess predisposing factors to IHT development. We conducted a systematic literature search...

    journal_title:Neurocritical care

    pub_type: 杂志文章,meta分析

    doi:10.1007/s12028-018-0658-x

    authors: Godoy DA,Núñez-Patiño RA,Zorrilla-Vaca A,Ziai WC,Hemphill JC 3rd

    更新日期:2019-08-01 00:00:00

  • Therapeutic hypothermia for acute liver failure: toward a randomized, controlled trial in patients with advanced hepatic encephalopathy.

    abstract::Acute liver failure (ALF), the abrupt loss of liver function in a patient without previous liver disease, remains a highly mortal condition. Patients with ALF often succumb to their liver injury after the development of cerebral edema, resulting in intracranial hypertension and brain herniation. While the management o...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-008-9090-y

    authors: Stravitz RT,Lee WM,Kramer AH,Kramer DJ,Hynan L,Blei AT

    更新日期:2008-01-01 00:00:00

  • Informatics for neurocritical care: challenges and opportunities.

    abstract::Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-013-9872-8

    authors: Sivaganesan A,Manley GT,Huang MC

    更新日期:2014-02-01 00:00:00

  • The Feasibility, Safety and Effectiveness of a Ketogenic Diet for Refractory Status Epilepticus in Adults in the Intensive Care Unit.

    abstract:BACKGROUND:Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU). METHODS:We...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-018-0653-2

    authors: Francis BA,Fillenworth J,Gorelick P,Karanec K,Tanner A

    更新日期:2019-06-01 00:00:00

  • Blood Pressure Guideline Adherence in Patients with Ischemic and Hemorrhagic Stroke in the Neurointensive Care Unit Setting.

    abstract:BACKGROUND AND PURPOSE:Patients with acute brain injuries require strict physiologic control to minimize morbidity and mortality. This study aimed to assess in-hospital compliance to strict physiologic parameters (BP, HR, ICP, SpO2) in these populations. METHODS:Patients with severe cerebrovascular events were admitte...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-015-0116-y

    authors: Porto GB,Spiotta AM,Chalela JA,Kellogg RT,Jauch EC

    更新日期:2015-12-01 00:00:00

  • Treatment of Hyponatremia in Patients with Acute Neurological Injury.

    abstract:BACKGROUND:Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS:This retrospective, multicenter, observational study identified 400 ICU p...

    journal_title:Neurocritical care

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s12028-016-0343-x

    authors: Human T,Cook AM,Anger B,Bledsoe K,Castle A,Deen D,Gibbs H,Lesch C,Liang N,McAllen K,Morrison C,Parker D Jr,Rowe AS,Rhoney D,Sangha K,Santayana E,Taylor S,Tesoro E,Brophy G

    更新日期:2017-10-01 00:00:00

  • Does prone positioning increase intracranial pressure? A retrospective analysis of patients with acute brain injury and acute respiratory failure.

    abstract:PURPOSE:The objective of our trial was to obtain more comprehensive data on the risks and benefits of kinetic therapy in intensive care patients with intracerebral pathology. METHODS:Standardized data of prone positioning in our NeuroIntensive Care Unit were collected from 2007 onward. A post hoc analysis of all avail...

    journal_title:Neurocritical care

    pub_type: 临床试验,杂志文章

    doi:10.1007/s12028-014-0004-x

    authors: Roth C,Ferbert A,Deinsberger W,Kleffmann J,Kästner S,Godau J,Schüler M,Tryba M,Gehling M

    更新日期:2014-10-01 00:00:00