Prophylactic, Endovascularly Based, Long-Term Normothermia in ICU Patients With Severe Cerebrovascular Disease

• DOI: 10.1161/strokeaha.109.557652
• Publication Date: 2009-09-18T05:34:49Z
• Authors: Gregor Broessner; Ronny Beer; Peter Lackner; Raimund Helbok; Marlene Fischer; Bettina Pfausler; Janelle Rhorer; Lea Küppers-Tiedt; Dietmar Schneider; Erich Schmutzhard
• Keywords: Stroke

Background and Purpose— We sought to study the effectiveness safety of endovascular cooling maintain prophylactic normothermia in comparison with standardized, stepwise, escalating fever management reduce burden patients severe cerebrovascular disease. Methods— This was a prospective, randomized, controlled trial blinded neurologic outcome evaluation between prophylactic, catheter-based (CoolGard; ie, body core temperature 36.5°C) conventional, stepwise anti-inflammatory drugs surface cooling. Patients admitted 1 2 neurointensive care units were eligible for inclusion when they had (1) spontaneous subarachnoid hemorrhage Hunt & Hess grade 3 5, (2) intracerebral Glasgow Coma Scale score ≤10, or (3) complicated cerebral infarction requiring intensive unit treatment National Institutes Health Stroke ≥15. Results— A total 102 (56 female) enrolled during 3.5-year period. Fifty percent hemorrhage, 40% 10% infarction. Overall median course 0.0°C hour 4.3°C hours catheter conventional groups, respectively ( P <0.0001). Prophylactic did not lead an increase number who experienced major adverse event. No significant difference found mortality long-term follow-up. Conclusions— Long-term, catheter-based, significantly reduces disease is associated increased events.