Abstract:
:Targeted temperature management (TTM) is an important treatment modality in pediatric neurocritical care. There are different types of devices available to deliver this therapy, but limited pediatric data exist. This quality improvement study evaluates the use of a surface cooling device that uses gel-adhesive pads for TTM in critically ill pediatric patients. An institutional TTM protocol to use the gel-adhesive pad system was developed with three different temperature goals: normothermia (goal temperature 37°C), mild hypothermia (goal temperature 35°C with rewarming duration of 12 hours to normothermia), and moderate hypothermia (goal temperature 33°C with rewarming duration of 24 hours to normothermia). Protocol and device implementation required several different educational sessions for all members of the critical care team. An exploratory analysis was performed for 19 patients with complete clinical and device temperature data. The most common protocol used was normothermia (73.6%). By protocol, time to goal temperature was 58 minutes (22.0-112.8) for normothermia, 46.5 minutes (44.3-48.8) for mild hypothermia, and 93 minutes (46.5-406.5) for moderate hypothermia. Patients remained within ±0.5°C temperature goal 99% (96.0-99.3) of the time in the normothermia protocol, 99.5% (99-100) in mild hypothermia, and 93% (80-100) for the moderate hypothermia protocol. Shivering was the most common adverse event (35%). Our results show that use of the gel-adhesive pad system for pediatric TTM is feasible, efficacious with regard to achieving both a short time to target temperature and maintaining temperature goal, and, in this limited sample, was free from major adverse events. We also defined several technical aspects of device use in pediatric patients that should be considered in future trial design and/or clinical use. Further studies are needed to determine if this device is superior to other cooling devices for temperature management in the pediatric population.
journal_name
Ther Hypothermia Temp Managjournal_title
Therapeutic hypothermia and temperature managementauthors
Alcamo AM,Lavezoli R,Dezfulian C,Simon DW,Aneja RK,Clark RSB,Kochanek PM,Fink ELdoi
10.1089/ther.2020.0011subject
Has Abstractpub_date
2020-05-19 00:00:00eissn
2153-7658issn
2153-7933pub_type
杂志文章abstract::Interleukin-6 (IL-6) is a proinflammatory cytokine that may play multiple roles in the pathogenesis of traumatic brain injury (TBI). The present study determined time-dependent changes in IL-6 concentrations in vulnerable brain regions, cerebrospinal fluid (CSF) samples, and plasma after normothermic TBI. Because seco...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2012.0016
更新日期:2012-12-01 00:00:00
abstract::Perinatal hypoxic ischemic encephalopathy (HIE) can lead to severe neurodevelopmental outcome and death. Therapeutic hypothermia is neuroprotective for infants with moderate-to-severe HIE. However, therapeutic hypothermia is only offered at high-level regional neonatal intensive care units (NICUs), necessitating the n...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2016.0022
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The use of therapeutic hypothermia (TH) is a burgeoning treatment modality for post-cardiac arrest patients. OBJECTIVES:We performed a retrospective chart review of patients who underwent post-cardiac arrest TH at eight different institutions across the United States. Our objectives were to assess how TH is...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2012.0015
更新日期:2012-09-01 00:00:00
abstract::While commonly described, no studies have characterized cold-induced diuresis or rewarm anti-diuresis occurring during the delivery of therapeutic hypothermia (TH). We sought to determine urine output changes during the provision of postcardiac arrest TH. We analyzed clinical data on patients receiving postcardiac arr...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2013.0015
更新日期:2013-12-01 00:00:00
abstract::Intracerebral hemorrhage (ICH) is often a devastating stroke, and there are no clinically proven neuroprotective treatments. Considerable research points to iron toxicity as a leading contributor to secondary damage after ICH. Iron, released from degraded erythrocytes, catalyzes free radical production, thereby causin...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2015.0020
更新日期:2016-03-01 00:00:00
abstract::Therapeutic hypothermia was first recommended as a standard of care by international guidelines in 2010. However, at that time, the number of centers capable of providing standard cooling was limited even in Japan. The aim of this project was to implement a nationwide network of evidence-based cooling within 3 years. ...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2014.0015
更新日期:2014-12-01 00:00:00
abstract::Targeted temperature management (TTM) has been used to improve neurological recovery in comatose patients after out-of-hospital cardiac arrest (OHCA). Hypertension (HTN) existing before a cardiac arrest represents a risk of OHCA, but it is not known whether it affects neurological prognosis. This study aimed at invest...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2019.0015
更新日期:2020-09-01 00:00:00
abstract::This study was done to determine the effectiveness of therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) among a large cohort of adults in the Cardiac Arrest Registry to Enhance Survival (CARES), with an emphasis on subgroups with a nonshockable first documented rhythm. This was an IRB approved r...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2013.0018
更新日期:2014-03-01 00:00:00
abstract::Fever increases mortality and morbidity and length of stay in neurocritically ill patients. Various methods are used in the neuroscience intensive care unit (NSICU) to control fever. Two such methods involve the Arctic Sun hydrogel wraps and the Gaymar cooling wraps. The purpose of our study was to compare these two m...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2016.0031
更新日期:2017-09-01 00:00:00
abstract::Traumatic brain injury (TBI) is a significant cause of disability and death and a huge economic burden throughout the world. Much of the morbidity associated with TBI is attributed to secondary brain injuries resulting in hypoxia and ischemia after the initial trauma. Intracranial hypertension and decreased partial br...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章,随机对照试验
doi:10.1089/ther.2015.0002
更新日期:2015-09-01 00:00:00
abstract::A middle age man underwent immediate cardiopulmonary resuscitation (CPR) for ventricular fibrillation (VF) occurred in an ambulance. After arrival in a regional hospital, return of spontaneous circulation (ROSC) was achieved 82 minutes after the collapse. He was in coma even three hours after ROSC. So, he was transfer...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2014.0021
更新日期:2015-03-01 00:00:00
abstract::A 34-year-old man with uncontrolled hypertension suffered a ventricular fibrillation cardiac arrest from an obstructive left anterior descending artery occlusion. He was defibrillated more than 10 times before achieving return of spontaneous circulation. He was comatose after his arrest and was treated with therapeuti...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2013.0016
更新日期:2013-12-01 00:00:00
abstract::Loss of pupillary light reactivity is one recognized indicator of poor prognosis after cardiopulmonary resuscitation (CPR). However, drug overdose, low cardiac output, and/or resuscitation drugs can lead to impaired pupillary light reflex. To investigate pupillary light reflex status before therapeutic hypothermia (TH...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2015.0035
更新日期:2016-08-01 00:00:00
abstract::The aim of this study was to report on fever epidemiology and management strategies within a general population of critically ill patients. This was a retrospective cohort study among febrile patients (temperature ≥38.3°C) without acute brain injury admitted to one of four regional adult intensive care units (ICUs). T...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2011.0002
更新日期:2011-01-01 00:00:00
abstract::A feasibility study was performed to compare an investigational drug, HBN-1, to forced cooling to induce hypothermia after resuscitation in a translation model of asphyxial cardiac arrest in swine. Serum and cerebral spinal fluid neuron-specific enolase activity (sNSE and csfNSE) were measured after cardiac arrest as ...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2012.0017
更新日期:2012-12-01 00:00:00
abstract::Reperfusion therapies for stroke diminish in effectiveness and safety as time to treatment increases. Hypothermia neuroprotection for stroke is established, but its clinical translation has been hampered by uncertainties regarding optimal temperature and complications associated with moderate hypothermia. Also, hypoth...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2015.0010
更新日期:2015-12-01 00:00:00
abstract::The aim was to investigate blood concentrations of copeptin and the prognostication in 24 versus 48 hours of targeted temperature management (TTM) in patients resuscitated after out-of-hospital cardiac arrest. This is an exploratory biomarker substudy of the trial entitled; "Targeted temperature management for 48 vs 2...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2020.0030
更新日期:2020-09-25 00:00:00
abstract::To evaluate the safety and feasibility of modest hypothermia as a potential strategy for intraoperative neuroprotection during the removal of intradural spinal tumors. A retrospective review was performed for two groups of patients of a single surgeon who underwent intradural extrameduallary and intramedullary spinal ...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2014.0006
更新日期:2014-09-01 00:00:00
abstract::Therapeutic hypothermia acts as the standard of care for infants with moderate to severe hypoxic ischemic encephalopathy (HIE). A proportion of neonates who undergo hypothermia due to HIE have shown to develop various degrees of hearing impairment. Analyzing and identifying infants at high risk of developing hearing d...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2020.0043
更新日期:2021-01-28 00:00:00
abstract::Emergent modification of a patient's body temperature is crucial in certain disease or injury states. Advanced targeted temperature management techniques such as central venous catheter devices are not universally available, however, virtually all medical centers have access to intravenous fluids. This study approxima...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2020.0036
更新日期:2020-11-02 00:00:00
abstract::Treatment with mild hypothermia induced after cardiopulmonary resuscitation has become a standard of care, but optimal timing and duration of hypothermia remains unclear. We present a 66-year-old man admitted after an out-of-hospital cardiac arrest. Because of his severe hypoxemia, cardiopulmonary instability, and res...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2013.0009
更新日期:2013-06-01 00:00:00
abstract::Targeted temperature management (TTM) may improve respiratory mechanics and lung inflammation in acute respiratory distress syndrome (ARDS) based on animal and limited human studies. We aimed to assess the pulmonary effects of TTM in patients with respiratory failure following cardiac arrest. Retrospective review of c...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2014.0004
更新日期:2014-06-01 00:00:00
abstract::Rebound hyperthermia (RH) is frequently seen after completion of targeted temperature management (TTM) in comatose survivors of cardiac arrest. However, its clinical significance is not well understood. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpos...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章,meta分析,评审
doi:10.1089/ther.2017.0009
更新日期:2017-12-01 00:00:00
abstract::Targeted temperature management (TTM) improves survival and neurological outcome after nontraumatic cardiac arrest. However, TTM is not used widely after traumatic cardiac arrest because of concerns that it might exacerbate bleeding. We report the use of postarrest TTM after repair of blunt myocardial rupture. A 48-ye...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2016.0029
更新日期:2017-03-01 00:00:00
abstract::Postcardiac arrest patients are at high risk for developing venous thromboembolism (VTE). Current postarrest guidelines do not provide recommendations for prevention or surveillance of VTE and there is little guidance regarding the optimal prophylaxis or treatment of VTE during therapeutic hypothermia (TH). Many patie...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2015.0019
更新日期:2015-12-01 00:00:00
abstract::Urgent coronary angiography following cardiac arrest is an important consideration as part of a therapeutic hypothermia/postresuscitation care bundle. Few data exist to guide the selection of patients who should receive postarrest angiography. This investigation sought to evaluate patient-level variables on initial po...
journal_title:Therapeutic hypothermia and temperature management
pub_type: 杂志文章
doi:10.1089/ther.2012.0012
更新日期:2012-06-01 00:00:00