Mechanism and Control of Centrally Induced Cardiac Irregularities During Hypothermia

Pool, James L.; Kessler, Laibe A.

doi:10.3171/jns.1958.15.1.0052

Cited by 26 publications

(9 citation statements)

References 11 publications

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“…However, the clinical application of this treatment procedure was limited because of the deep hypothermia associated complications with respect to heart rate, infection, etc., [14,15]. Mild hypothermia (33°C) was first reported in 1987 by Busto et al [16] for its significant protective effect on neurons against ischemia and since then the mild hypothermia as a treatment for brain protection has been widely used in conditions of head trauma and cerebral vascular diseases.…”

Section: Discussionmentioning

confidence: 98%

Influence of Plasma and Cerebrospinal Fluid Levels of Endothelin-1 and No in Reducing Cerebral Vasospasm after Subarachnoid Hemorrhage During Treatment with Mild Hypothermia, in a Dog Model

Wang

Chen

2011

Cell Biochem Biophys

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Using vascular heat-exchange controller implemented mild hypothermia treatment, the authors established the cerebral vasospasm model in which blood was injected twice into dog's foramen magnum; and it was discussed the influence of the concentration of endothelin-1 and NO in blood plasma and cerebrospinal fluid through continuing treatment of mild hypothermia at different times in secondary brain vasospasm model after subarachnoid hemorrhage. Thirty healthy mongrel dogs were randomly divided into five groups; artificial cerebrospinal fluid group (group A), normal temperature control group (group C), mild hypothermia 8 h group (group H1), mild hypothermia 16 h group (group H2), and mild hypothermia 32 h group (group H3). The authors injected the artificial CSF into dog's foramen magnum in group A while the other four groups were injected with autologous arterial blood. The normal group's temperature maintained 38.5°C. The authors set the temperature at 33.5°C in mild hypothermia groups and this was maintained for 8, 16, and 32 h, respectively. ET-1 and NO levels in the cerebrospinal fluid and plasma were assayed in each group on days 0, 7, 14, and 21. Then the changes of the diameter of blood vessels of cerebral basilar artery and overall performance categories score in each group through application of CT angiography were recorded. In the cerebral vasospasm model which was constructed by injecting the blood to dog twice, mild hypothermia treatment, through the application of vascular heat-exchange controller, could reduce cerebral vasospasm. It was observed that the duration of the mild hypothermia is directly proportional to the longer duration of the relieving of cerebral vasospasm. The reciprocal changes observed in the levels of ET-1 and NO in cerebrospinal fluid and plasma revealed that it might be possible to reduce the cerebral vasospasm by regulating the rising amplitude of ET-1 and the decrease in NO in CSF and plasma.

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Section: Discussionmentioning

confidence: 98%

Influence of Plasma and Cerebrospinal Fluid Levels of Endothelin-1 and No in Reducing Cerebral Vasospasm after Subarachnoid Hemorrhage During Treatment with Mild Hypothermia, in a Dog Model

Wang

Chen

2011

Cell Biochem Biophys

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“…62 Initial interest in modern medicine for the neuroprotective value of hypothermic therapy in head trauma was dampened by major side effects of deep hypothermia, such as lethal cardiac ventricular arrythmia reported in the 1950s. 65,66 However, with multiple studies demonstrating the efficacy of mild to moderate hypothermia and the advent of critical care units to monitor major side effects, a few clinical trials have again rekindled interest in utilizing hypothermia for neuroprotection in a small population of post-cardiac arrest patients. 67-87 …”

Section: Bedside Clinical Proteomic Profiling May Offer Insights mentioning

confidence: 99%

Pharmaco-proteomics opportunities for individualizing neurovascular treatment

Ning

Lopez

Sarracino

et al. 2013

Neurological Research

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Neurovascular disease often involves multi-organ system injury. For example, patent foramen ovale (PFO) related ischemic strokes involve not just the brain, but also the heart, the lung, and the peripheral vascular circulation. For higher-risk but high-reward systemic therapy (e.g., thrombolytics, therapeutic hypothermia, PFO closure) to be implemented safely, very careful patient selection and close monitoring of disease progression and therapeutic efficacy are imperative. For example, more than a decade after the approval of therapeutic hypothermic and intravenous thrombolysis treatments, they both remain extremely underutilized, in part due to lack of clinical tools for patient selection or to follow therapeutic efficacy. Therefore, in order to understand the complexity of the global effects of clinical neurovascular diseases and their therapies, a systemic approach may offer a unique perspective and provide tools with clinical utility. Clinical proteomic approaches may be promising to monitor systemic changes in complex multi-organ diseases – especially where the disease process can be “sampled” in clinically accessible fluid such as blood, urine and CSF. Here, we describe a “pharmaco-proteomic” approach to three major challenges in translational neurovascular research directly at bedside – in order to better stratify risk, widen therapeutic windows, explore novel targets to be validated at the bench – 1) thrombolytic treatment for ischemic stroke, 2) therapeutic hypothermia for post cardiac arrest syndrome, and 3) treatment for patent foramen ovale (PFO) related paradoxical embolic stroke. In the future, this clinical proteomics approach may help to improve patient selection, ensure more precise clinical phenotyping for clinical trials, and individualize patient treatment.

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“…6 We have noted, in addition, that local application of 2% procaine or 3% papaverine to the constricted portion of the artery with a small cotton pledget may then result in vasodilatation. However, vaso¬ spasm already present as a result of hemorrhage from an aneurysm3 may not always be relieved by topical applications of these drugs at operation.…”

Section: Clinical Datamentioning

confidence: 98%