Therapeutic Efficacy of Craniocerebral Hypothermia Helmet Versus Arctic Sun Surface Cooling System in Post-Cardiac Arrest Syndrome: A Prospective Comparative Study.

IF 0.8 4区 医学 Q4 CRITICAL CARE MEDICINE Therapeutic hypothermia and temperature management Pub Date : 2025-03-17 DOI:10.1089/ther.2025.0006
Aydin Nadir, Mehmet Sari
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Abstract

Therapeutic hypothermia is a critical intervention in post-cardiac arrest care, yet the optimal cooling method remains debatable. This prospective, single-center study compared the efficacy of a novel craniocerebral hypothermia helmet with the Arctic Sun 5000 surface cooling system in post-cardiac arrest patients. Thirty-four comatose survivors of cardiac arrest were randomized to receive either craniocerebral hypothermia (n = 17) or peripheral surface cooling (n = 17). Target temperature management (32-34°C) was initiated within 30-120 minutes of return of spontaneous circulation and maintained for 36-48 hours. Craniocerebral hypothermia demonstrated significantly faster cooling initiation (32.9 ± 13.5 vs. 238 ± 25.7 minutes, p < 0.001) compared with peripheral cooling, while both methods achieved similar target temperature maintenance. The craniocerebral group showed better preservation of renal function and electrolyte stability, with significantly lower increases in serum creatinine and urea levels (p < 0.001). Hospital stays were notably shorter in the craniocerebral group (13 ± 7 vs. 24.29 ± 31 days, p < 0.001). While both methods achieved comparable survival rates, the craniocerebral group exhibited a lower incidence of seizures (17.6% vs. 66.6%) and improved neurological outcomes based on Cerebral Performance Category scores though not reaching statistical significance. These findings suggest that craniocerebral hypothermia offers advantages in terms of rapid cooling initiation, physiological stability, and reduced hospital stay, representing a promising alternative for targeted temperature management in post-cardiac arrest care. The enhanced practicality and comparable efficacy of this approach warrant further investigation through larger multicenter trials.

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治疗性低温是心脏骤停术后护理中的一项重要干预措施,但最佳降温方法仍存在争议。这项前瞻性单中心研究比较了新型颅脑低温头盔和 Arctic Sun 5000 表面冷却系统对心脏骤停后患者的疗效。34 名心脏骤停的昏迷幸存者被随机分配接受颅脑低温治疗(17 人)或外周表面冷却(17 人)。目标体温管理(32-34°C)在自主循环恢复后 30-120 分钟内启动,并维持 36-48 小时。与外周体表降温相比,颅脑降温的启动速度明显更快(32.9 ± 13.5 分钟 vs. 238 ± 25.7 分钟,p < 0.001),而两种方法的目标体温维持时间相似。颅脑组对肾功能和电解质稳定性的保护更好,血清肌酐和尿素水平的升高明显较低(p < 0.001)。颅脑手术组的住院时间明显更短(13 ± 7 对 24.29 ± 31 天,P < 0.001)。虽然两种方法的存活率相当,但颅脑手术组的癫痫发作率较低(17.6% 对 66.6%),而且根据脑功能分类评分,神经系统预后也有所改善,但未达到统计学意义。这些研究结果表明,颅脑低温疗法在快速开始降温、生理稳定和缩短住院时间方面具有优势,是心脏骤停后护理中针对性体温管理的一种很有前途的替代方法。这种方法具有更强的实用性和可比疗效,值得通过更大规模的多中心试验进行进一步研究。
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来源期刊
CiteScore
2.50
自引率
8.30%
发文量
35
期刊介绍: Therapeutic Hypothermia and Temperature Management is the first and only journal to cover all aspects of hypothermia and temperature considerations relevant to this exciting field, including its application in cardiac arrest, spinal cord and traumatic brain injury, stroke, burns, and much more. The Journal provides a strong multidisciplinary forum to ensure that research advances are well disseminated, and that therapeutic hypothermia is well understood and used effectively to enhance patient outcomes. Novel findings from translational preclinical investigations as well as clinical studies and trials are featured in original articles, state-of-the-art review articles, protocols and best practices. Therapeutic Hypothermia and Temperature Management coverage includes: Temperature mechanisms and cooling strategies Protocols, risk factors, and drug interventions Intraoperative considerations Post-resuscitation cooling ICU management.
期刊最新文献
Therapeutic Efficacy of Craniocerebral Hypothermia Helmet Versus Arctic Sun Surface Cooling System in Post-Cardiac Arrest Syndrome: A Prospective Comparative Study. Changes Over 7 Years in Temperature Control Treatment and Outcomes After Out-of-Hospital Cardiac Arrest: A Japanese, Multicenter Cohort Study. The Relationship of Perioperative Inadvertent Hypothermia with Anxiety and Comfort. Comparing Hypothermic and Thermal Neutral Conditions to Induce Metabolic Suppression. The Effectiveness of Target Temperature Management on Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.
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