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Effect and feasibility of controlled rewarming after moderate hypothermia in stroke patients with malignant infarction of the middle cerebral artery.

Steiner, Thorsten and Friede, Tim and Aschoff, Alfred and Schellinger, Peter Dieter and Schwab, Stefan and Hacke, Werner (2001) Effect and feasibility of controlled rewarming after moderate hypothermia in stroke patients with malignant infarction of the middle cerebral artery. Stroke, 32 (12). pp. 2833-2835.

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Abstract

Background and Purpose-: Moderate hypothermia has been found to reduce intracranial pressure (ICP) significantly in patients who have severe middle cerebral artery infarction. However, during passive rewarming, ICP continuously rises and some patients suffer transtentorial herniation. Methods-: We investigated the question of whether slower rewarming leads to slower increase in ICP and slower decrease in cerebral perfusion pressure (CPP). Furthermore, we studied feasibility of slow, controlled rewarming. ICP, CPP, and core body temperature were monitored continuously. Achievement of rewarming protocol was assessed by hit rate of temperature target intervals. Side effects of hypothermia were assessed. Results-: Rates of change of both ICP and CPP were correlated significantly with increase in temperature (ICP r =0.62, P =0.002; CPP r =-0.50, P =0.017). In feasibility analysis of 13 controlled rewarmed patients, hit rate of temperature target intervals was 63% (median; range 48% to 81%); hit rate within the target interval or below was 79% (median; range 62% to 94%). Conclusions-: Slow, controlled rewarming is feasible and may be used for ICP and CPP control after moderate hypothermia for space-occupying infarction.

Item Type: Article
Journal or Publication Title: Stroke
Uncontrolled Keywords: stroke ; ischemic • brain edema • intracranial pressure • hypothermia
Subjects: Q Science > QA Mathematics
Departments: Faculty of Science and Technology > Mathematics and Statistics
ID Code: 19324
Deposited By: ep_ss_importer
Deposited On: 21 Nov 2008 11:07
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 15:28
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/19324

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