Comparison of Endovascular and Surface Cooling during Unruptured Cerebral Aneurysm Repair

• DOI: 10.1227/01.neu.0000129683.99430.8c
• Publication Date: 2004-08-17T23:17:49Z
• Authors: Gary K. Steinberg; Christopher S. Og...; Lawrence M. Shuer; E. Sander Connolly; Robert A. Solomon; Arthur Lam; Neal F. Kassell; Christopher J. Baker; Steven L. Giannotta; Kevin M. Cockroft; Teresa E. Bell-St...; Robin L. Allgren
• Keywords: Adult; Male; Catheterization, Central Venous; Technology Assessment, Biomedical; Adolescent; Equipment Safety; Glasgow Outcome Scale; Intracranial Aneurysm; Vena Cava, Inferior; Equipment Design; Middle Aged; Cerebral Angiography; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Hypothermia, Induced; Humans; Female; Craniotomy; Aged; Body Temperature Regulation

Abstract OBJECTIVE: To compare endovascular versus surface methods for the induction and reversal of hypothermia during neurosurgery in a multicenter, prospective, randomized study. METHODS: Patients undergoing elective open craniotomy repair an unruptured cerebral aneurysm (n = 153) were randomly assigned (2:1) to undergo whole-body 33°C, either with cooling device placed inferior vena cava via femoral vein 92) or convective air blanket 61). Active rewarming was accomplished using same devices. RESULTS: Cooling rates groups averaged 4.77 0.87°C/h, respectively (P < 0.001). When first temporary arterial clip placed, 99% patients 20% had reached target 33°C Obese cooled efficiently approach (3.56°C/h). Rewarming 1.88°C/h 0.69°C/h By end surgery, 89 53% these patients, respectively, rewarmed at least 35°C On leaving operating room, 14% 28% still intubated 0.035). The overall safety two procedures comparable. No clinically significant catheter-related thrombotic, bleeding, infectious complications reported group. CONCLUSION: Endovascular provided superior induction, maintenance, compared blanket, without increase complications. may have clinical benefit cerebrovascular as well acute stroke, head injury, myocardial infarction.