| Therapeutic hypothermia for acute ischemic stroke: ready to start large randomized trials? | |
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MedLine Citation:
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PMID: 20354545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Therapeutic hypothermia is a means of neuroprotection well established in the management of acute ischemic brain injuries such as anoxic encephalopathy after cardiac arrest and perinatal asphyxia. As such, it is the only neuroprotective strategy for which there is robust evidence for efficacy. Although there is overwhelming evidence from animal studies that cooling also improves outcome after focal cerebral ischemia, this has not been adequately tested in patients with acute ischemic stroke. There are still some uncertainties about crucial factors relating to the delivery of hypothermia, and the resolution of these would allow improvements in the design of phase III studies in these patients and improvements in the prospects for successful translation. In this study, we discuss critical issues relating first to the targets for therapy including the optimal depth and duration of cooling, second to practical issues including the methods of cooling and the management of shivering, and finally, of factors relating to the design of clinical trials. Consideration of these factors should inform the development of strategies to establish beyond doubt the place of hypothermia in the management of acute ischemic stroke. |
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Authors:
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H Bart van der Worp; Malcolm R Macleod; Rainer Kollmar; |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-03-31 |
Journal Detail:
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Title: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Volume: 30 ISSN: 1559-7016 ISO Abbreviation: J. Cereb. Blood Flow Metab. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-01 Completed Date: 2010-06-17 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 8112566 Medline TA: J Cereb Blood Flow Metab Country: United States |
Other Details:
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Languages: eng Pagination: 1079-93 Citation Subset: IM |
Affiliation:
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Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Brain Ischemia / therapy* Clinical Trials, Phase III as Topic Humans Hypothermia, Induced* Randomized Controlled Trials as Topic Stroke / therapy* |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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