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Open Access 01-12-2019 | Stroke | Letter

Hypothermia after decompressive hemicraniectomy in treatment of malignant middle cerebral artery stroke: comment on the randomized clinical trial

Authors: N. Engrand, M. Mazighi, V. Dinkelacker

Published in: Critical Care | Issue 1/2019

Excerpt

Therapeutic hypothermia (TH) is currently evaluated in acute brain injury of diverse etiologies. In the clinical trial DEPTH-SOS, Neugebauer et al. [1] reported negative results for TH (33 ± 1 °C) in malignant acute ischemic stroke (AIS) in adjunction to decompressive hemicraniectomy. TH improved neither survival at day 14 or at 12 months, nor long-term functional outcome. Instead, severe adverse events (SAE) in the TH-group entailed premature trial discontinuation. We revisit the study design with regard to its clinical objectives. …

Neugebauer H, Schneider H, Bösel J, et al. Outcomes of hypothermia in addition to decompressive hemicraniectomy in treatment of malignant middle cerebral artery stroke: a randomized clinical trial. JAMA Neurol. 2019. https://doi.org/10.1001/jamaneurol.2018.4822.CrossRef

Vigué B, Ract C, Zlotine N, et al. Relationship between intracranial pressure, mild hypothermia and temperature-corrected PaCO2 in patients with traumatic brain injury. Intensive Care Med. 2000;26:722–8.CrossRef

Voicu S, Deye N, Malissin I, et al. Influence of α-stat and pH-stat blood gas management strategies on cerebral blood flow and oxygenation in patients treated with therapeutic hypothermia after out-of-hospital cardiac arrest: a crossover study. Crit Care Med. 2014;42:1849–61. https://doi.org/10.1097/CCM.0000000000000339.CrossRefPubMed

Ebner F, Harmon MBA, Aneman A. Carbon dioxide dynamics in relation to neurological outcome in resuscitated out-of-hospital cardiac arrest patients: an exploratory Target Temperature Management Trial substudy. Crit Care. 2018;22:196. https://doi.org/10.1186/s13054-018-2119-5.CrossRefPubMedPubMedCentral

Title: Hypothermia after decompressive hemicraniectomy in treatment of malignant middle cerebral artery stroke: comment on the randomized clinical trial
Authors: N. Engrand
M. Mazighi
V. Dinkelacker
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Stroke
Intracranial Hypertension
Published in: Critical Care / Issue 1/2019
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-019-2452-3

At a glance: The STEP trials

Springer Medicine

Hypothermia after decompressive hemicraniectomy in treatment of malignant middle cerebral artery stroke: comment on the randomized clinical trial

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

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