Document Detail

Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: bicenter prospective, randomized trial.
MedLine Citation:
PMID:  19762706     Owner:  NLM     Status:  MEDLINE    
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 degrees 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 <or=10, or (3) complicated cerebral infarction requiring intensive care unit treatment with a National Institutes of Health Stroke Scale score >or=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 degrees C hour and 4.3 degrees 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.
Gregor Broessner; Ronny Beer; Peter Lackner; Raimund Helbok; Marlene Fischer; Bettina Pfausler; Janelle Rhorer; Lea K??ppers-Tiedt; Dietmar Schneider; Erich Schmutzhard
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-09-17
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e657-65     Citation Subset:  IM    
Department of Neurology, Neurologic Intensive Care Unit, Innsbruck Medical University, Innsbruck, Austria.
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MeSH Terms
Anti-Inflammatory Agents / therapeutic use
Body Temperature Regulation / physiology*
Cerebral Hemorrhage / complications
Cerebral Infarction / complications
Cerebrovascular Disorders / complications*
Clinical Protocols
Equipment and Supplies
Fever / etiology*,  prevention & control,  therapy*
Hypothermia, Induced / adverse effects,  methods*
Intensive Care Units
Middle Aged
Pilot Projects
Prospective Studies
Single-Blind Method
Subarachnoid Hemorrhage / complications
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Anti-Inflammatory Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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