therapeutic hypothermia in acute stroke

... problem with surface cooling is cold injury, causing pressure ulcers and Therapeutic Hypothermia in Brain Injury skin breakdown Surface cooling is less efficient in reducing the temperature of ... ischemia-reperfusion injury leading to intravascular clot formation resulting in microvascular thrombosis in the brain [42,43] Therapeutic Hypothermia could be beneficial in this instance since platelets ... temperature modulation in therapeutic hypothermia2 Temperature modulation during therapeutic hypothermia may be broken down into four phases: induction, maintenance, rewarming/ decooling, and normothermia...

Ngày tải lên: 06/03/2014, 23:20

... AHA guideline on therapeutic hypothermia will result in an increase in post-cardiac arrest patients receiving appropriate therapeutic hypothermia Methods/design The setting Figure Chain of survival ... lack of understanding of how to implement guidelines promoting the use of induced hypothermia in patients after OHCA; attitudes, i.e., clinicians’ low expectations regarding Dainty et al Implementation ... design used in this trial clinical outcomes for survivors of OHCA; and behaviour, i.e., barriers that interfere with clinicians successfully instituting induced hypothermia, for example insufficient...

Ngày tải lên: 10/08/2014, 10:23

... transfer in acute stroke Providing optimal inpatient care during the admission phase is essential if we are to combat the rising incidence of debilitating stroke Our CRCT will also allow us to test interventions ... acute stroke Neurology 2003, 60:620-625 National Stroke Foundation: Clinical Guidelines for Acute Stroke Managment Victoria: NSF; 2007 Clinical Excellence Commission: Quality of Health Care in ... multidisciplinary team-building intervention in ASUs Our intervention is designed to improve outcomes for patients admitted with acute stroke by better management of fever, hyperglycaemia, and swallowing...

Ngày tải lên: 11/08/2014, 16:20

... of bleeding in patients with acute myocardial infarction Int J Cardiol 2008 [Epub ahead of print] Hypothermia After Cardiac Arrest Study Group: Mild therapeutic hypothermia to improve the neurologic ... Hasper D: Therapeutic hypothermia after cardiac arrest – the implementation of the ILCOR guidelines in clinical routine is possible! [Letter.] Crit Care 2006, 10:425 Nolan JP, Deakin CD, Soar ... Competing interests The authors declare that they have no competing interests References Bruel C, Parienti JJ, Marie W, Arrot X, Daubin C, Du Cheyron D, Massetti M, Charbonneau P: Mild hypothermia...

Ngày tải lên: 13/08/2014, 08:21

... higher in the hypothermia group than in the normothermia group The CPA-ROSC in patients with a favorable neurological outcome was longer (P < 0.001) in the hypothermia group (median, 22 minutes; interquartile ... median (interquartile range) or n (%) Table In- hospital treatment and findings in the study patients Hypothermia group (n = 110) Normothermia group (n = 290) P value Dose of epinephrine (mg) ... less than minutes in the normothermia-M group with no one whose CPA-ROSC was less than minutes treated with hypothermia We thought that clinical signs, such as neurological findings, gasping and...

Ngày tải lên: 13/08/2014, 21:21

... of inducing hypothermia? Which level of hypothermia has to be induced? How long to maintain a certain level of hypothermia before re-warming? Induction of hypothermia during resuscitation Induction ... 60-90 minutes, requiring an additional cooling method to maintain mild hypothermia [40,41,58] Combination of cold intravenous fluids with cool-packs or cooling pads in the out-of-hospital setting ... paralytics during cooling, and the optimal re-warming rate after cooling, and to improve the techniques for inducing hypothermia We strongly encourage joining the international hypothermia network...

Ngày tải lên: 13/08/2014, 23:20

... and O2 saturation were within normal limits Laboratory findings are depicted in Table Drug screening was positive for opiates, benzodiazepine, amphetamine, methamphetamine and ecstasy The patient ... occurred after acute Table The patient’s laboratory findings during the first days after hospital admission Lab findings (reference limits) Admission ICU Day Day Day Day Day Troponin T (norm < ... Myocardial infarction with acute insulin poisoning- a case report Angiology 2000, 51:689-93 doi:10.1186/1757-7241-18-4 Cite this article as: Busch and Søreide: Successful use of therapeutic hypothermia...

Ngày tải lên: 13/08/2014, 23:21

... originally described as mediators for regulating the innate and adaptive immune systems Cytokines are thus upregulated in the brain in a variety of diseases, including stroke In the brain, cytokines ... pathways in acute ischemic stroke has become an important area of research in translational medicine Cytokines and brain inflammation Cytokines are a group of small glycoproteins that are produced in ... acute ischemic stroke remains one of the major challenges in clinical medicine This review will provide a brief overview of the current understanding of the inflammatory mechanisms involved in...

Ngày tải lên: 18/06/2014, 15:20

... extension in healthy subjects [23] While passive movements caused some increase in activation, active training led to more prominent increases in fMRI activation, recruitment curves (TMS) and intracortical ... electromechanical Finger Trainer to move individual fingers in a physiological range of movement This article describes the device and reports its use in a small number of chronic and acute stroke patients ... neurophysiological evidence in cats [29] and humans [30] that sensory stimulation induces long-term potentiation in the motor cortex, and increases corticospinal excitability In clinical studies of stroke patients,...

Ngày tải lên: 19/06/2014, 08:20

... as they could maintain the pace while avoiding running Subjects were verbally encouraged to maintain their pace Warnings were given when the participants got beyond a predetermined backward spatial ... fatigue is induced by treadmill walking or skiing, running or cycling also have been used [9-11] For example, Nardone et al [9], using a treadmill aerobic fatigue protocol, have reported increases ... to increase the central command intensity or to increase the firing rates of the motor units [1] The mutual interaction between the allocation of cognitive processing and balance control in a...

Ngày tải lên: 19/06/2014, 10:20

... measured in the clinical setting, and preferred gait speed is commonly used as an outcome measure of walking competency in stroke rehabilitation, having been shown to be able to detect minimally clinically ... used during the maximal exercise test and was selected to avoid the limitations in achieving aerobic capacity in sub -acute stroke using a walking or treadmill program The ramp protocol included ... training becomes increasingly recognized as an integral component of stroke rehabilitation programs during this important stage of recovery, valid and efficient tools for specifically evaluating...

Ngày tải lên: 19/06/2014, 10:20

... hypothesis is definitively investigated in a controlled trial Conclusion Fluctuations in blood pressure in the setting of acute ischemic stroke appear to impart a negative impact on stroke severity, ... variability in acute ischemic stroke depends on hemispheric stroke location Blood Press 2006;15(3):151-156 Marcheselli S, Cavallini A, Tosi P, Quaglini S, Micieli G Impaired blood pressure increase in acute ... baseline hypertension and death at 90 days, when defining baseline hypertension as baseline sBP = 170 mmHg and/or baseline dBP = 110 mmHg A total of 41.07% patients had baseline hypertension using...

Ngày tải lên: 20/06/2014, 20:20

... exam findings are often used in decision-making regarding transfers, this specific radiographic finding appears to add independent value in predicting tertiary care interventions Use of CTA in selected ... readily identified by physicians with minimal training in interpreting CTAs The original neuroimaging report was reviewed by a neuroradiologist, who was blinded to whether the patient received ... “blind” clinical decision makers to CTA findings In addition, our primary goal was to aid emergency physicians in predicting clinical options that would ultimately be offered to patients, and in...

Ngày tải lên: 20/06/2014, 22:20

... practice in intensive care units in the United Kingdom Anaesthesia 2006, 61:873-877 Sander M, von Heymann C, Spies C: Implementing the International Liaison Committee on Resuscitation guidelines on hypothermia ... et al.: Therapeutic hypothermia utilization among physicians after resuscitation from cardiac arrest Crit Care Med 2006, 34:1935-1940 Laver SR, Padkin A, Atalla A, Nolan JP: Therapeutic hypothermia...

Ngày tải lên: 13/08/2014, 03:20

... accumulating that multimodal CT or MRI, as compared with plain CT, provides information that is both useful in clinical trials and in the individual patient, even within the current 3-hour window In ... fluidattenuated inversion recovery (FLAIR) MRI can also demonstrate subarachnoid haemorrhage equally well [23] These findings may support the idea of omitting CT as the initial investigation in acute stroke ... on rewarming The current trend in ongoing trials is Finally, MRI is also being employed for selecting suitable candidates in trials of mechanical clot retrieval in posterior circulation stroke...

Ngày tải lên: 13/08/2014, 08:20

... baseline serum creatinine >2.0 mg/dl and female patients with a baseline serum creatinine >1.5 mg/dl were excluded from the trial The relatively low mean premorbid serum creatinine (1.1 mg/dl in ... score) In this regard, it is interesting to note that intensive IHD (in relatively well patients) was associated with a 33% increase in death risk relative to less-intensive IHD Conversely, intensive ... greater urea removal occurred in patients receiving less-intensive CRRT on a given day than in those receiving intensive IHD This uncertain separation of the dose during periods of unknown duration...

Ngày tải lên: 13/08/2014, 11:22

... [35] during sepsis or septic shock, indicating a potential role of infection and inflammation in the release of S-100 protein Due to the high infection rate in patients receiving MTH in our study, ... predominately found in astroFigure Figure Time course of S-100 protein S-100 protein serum levels in patients protein receiving mild therapeutic hypothermia (MTH) vs normothermia (NT) BL = baseline ... active warming was applied before induction of MTH Hypothermia was induced via infusion of one to two litres of cold (about 6°C) saline in combination with body surface cooling using bags filled...

Ngày tải lên: 13/08/2014, 16:20

... membrane The decline in COP in plasma was probably due to hemodilution, which is also reflected in a reduction in haemoglobin and erythrocyte volume fraction The reduction in COP in interstitial ... before initiation of CPR We found reduced fluid leakage to the interstitial space in the HH patients compared with controls Maintenance of intravascular COP is one important factor in determining ... remained unconscious At the scene, cooling was performed using icepacks placed on the neck, armpits and groin A Coolgard catheter (Alsius, California, USA) was installed in the right femoral vein...

Ngày tải lên: 13/08/2014, 23:21

... prevention of stroke with APS [4, 8, 9, 10] and concerning the relationship be- tween APS and stroke It is generally accepted that aPL is an independent risk factor for initial ischemic stroke in young ... was significantly more effective than low-intensity warfarin (INR under 3.0) with or without low-dose aspirin, or treatment with aspirin alone, in preventing further thrombotic events Crowther [7] ... difference in effectiveness for secondary prevention between single antiplatelet (aspirin) and single anticoagulant (warfarin) therapy Derksen [15] examined the effect of low-dose aspirin after...

Ngày tải lên: 26/10/2012, 09:48