Endovascular cooling for moderate hypothermia in patients with acute stroke - First results of a novel approach

被引:164
作者
Georgiadis, D [1 ]
Schwarz, S [1 ]
Kollmar, R [1 ]
Schwab, S [1 ]
机构
[1] Univ Heidelberg, Dept Neurol, D-69120 Heidelberg, Germany
关键词
stroke; acute; stroke management;
D O I
10.1161/hs1101.097382
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-We undertook this study to evaluate the feasibility of inducing and maintaining moderate hypothermia with the use of endovascular rather than surface cooling. Methods-Six patients with severe acute ischemic stroke were treated with moderate hypothermia. This was induced and maintained by circulating temperature-adjusted normal saline in a closed-loop system entailing 3 balloons located near the tip of a central line, which dwelled in the inferior vena cava. Results-The mean SD initial temperature of the patients was 37 +/- 1 degreesC (range, 35.5 degreesC to 38.4 degreesC). The pace of cooling was 1.4 +/- 0.6 degreesC/h, and target temperature was reached after 3 +/- 1 hours (range, 2 to 4.5 hours). During hypothermia, the maximal temperature observed was 33.4 degreesC, and the minimal temperature was 32.2 degreesC. Temperature deviations >0.2 degreesC or >0.3 degreesC were observed during 21% or 10% of the hours under hypothermia, respectively. Singultus was the only device-related complication encountered. Pulmonary infection, arterial hypotension, bradycardia, arrhythmia, and thrombocytopenia were the most common side effects. Conclusions-Induction and maintenance of hypothermia with an intravenous cooling device are feasible. The safety of this approach remains to be evaluated.
引用
收藏
页码:2550 / 2553
页数:4
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