Advanced

Feasibility of endovascular and surface cooling strategies in acute stroke

Ovesen, C.; Brizzi, Marco LU ; Pott, F. C.; Thorsen-Meyer, H. C.; Karlsson, Torbjörn LU ; Ersson, Anders LU ; Christensen, H.; Norrlin, A.; Meden, P. and Krieger, D. W., et al. (2013) In Acta Neurologica Scandinavica 127(6). p.399-405
Abstract
Background Therapeutic hypothermia (TH) is a promising treatment of stroke, but limited data are available regarding the safety and effectiveness of cooling methodology. We investigated the safety of TH and compared the cooling capacity of two widely used cooling strategies endovascular and surface cooling. Methods COOLAID Oresund is a bicentre randomized trial in Copenhagen (Denmark) and Malmo (Sweden). Patients were randomized to either TH (33 degrees C for 24h) in a general intensive care unit (ICU) or standardized stroke unit care (control). Cooling was induced by a surface or endovascular-based strategy. Results Thirty-one patients were randomized. Seven were cooled using endovascular and 10 using surface-based cooling methods and 14... (More)
Background Therapeutic hypothermia (TH) is a promising treatment of stroke, but limited data are available regarding the safety and effectiveness of cooling methodology. We investigated the safety of TH and compared the cooling capacity of two widely used cooling strategies endovascular and surface cooling. Methods COOLAID Oresund is a bicentre randomized trial in Copenhagen (Denmark) and Malmo (Sweden). Patients were randomized to either TH (33 degrees C for 24h) in a general intensive care unit (ICU) or standardized stroke unit care (control). Cooling was induced by a surface or endovascular-based strategy. Results Thirty-one patients were randomized. Seven were cooled using endovascular and 10 using surface-based cooling methods and 14 patients received standard care (controls). 14 (45%) patients received thrombolysis. Pneumonia was recorded in 6 (35%) TH patients and in 1 (7%) control. 4 TH patients and 1 control developed massive infarction. 1 TH patient and 2 control suffered asymptomatic haemorrhagic transformation. Mortality was comparable with 2 (12%) in the TH group and 1 (7%) among controls. Mean (SD) duration of hospital stay was 25.0days (24, 9) in TH and 22.5days (20.6) in control patients (P=0.767). Mean (SD) induction period (cooling onset to target temperature) was 126.3min (80.6) with endovascular cooling and 196.3min (76.3) with surface cooling (P=0.025). Conclusions Therapeutic hypothermia with general anaesthesia is feasible in stroke patients. We noticed increased rates of pneumonia, while the length of hospital stay remained comparable. The endovascular cooling strategy provides a faster induction period than surface cooling. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stroke, hypothermia, cerebral infarction, ischaemic stroke, acute stroke, therapy
in
Acta Neurologica Scandinavica
volume
127
issue
6
pages
399 - 405
publisher
Wiley-Blackwell
external identifiers
  • wos:000318948600005
  • scopus:84877924108
ISSN
1600-0404
DOI
10.1111/ane.12059
language
English
LU publication?
yes
id
3ca10b9c-f0a7-4766-8a13-8987934b8245 (old id 3932417)
date added to LUP
2013-08-01 07:41:07
date last changed
2019-02-20 04:58:02
@article{3ca10b9c-f0a7-4766-8a13-8987934b8245,
  abstract     = {Background Therapeutic hypothermia (TH) is a promising treatment of stroke, but limited data are available regarding the safety and effectiveness of cooling methodology. We investigated the safety of TH and compared the cooling capacity of two widely used cooling strategies endovascular and surface cooling. Methods COOLAID Oresund is a bicentre randomized trial in Copenhagen (Denmark) and Malmo (Sweden). Patients were randomized to either TH (33 degrees C for 24h) in a general intensive care unit (ICU) or standardized stroke unit care (control). Cooling was induced by a surface or endovascular-based strategy. Results Thirty-one patients were randomized. Seven were cooled using endovascular and 10 using surface-based cooling methods and 14 patients received standard care (controls). 14 (45%) patients received thrombolysis. Pneumonia was recorded in 6 (35%) TH patients and in 1 (7%) control. 4 TH patients and 1 control developed massive infarction. 1 TH patient and 2 control suffered asymptomatic haemorrhagic transformation. Mortality was comparable with 2 (12%) in the TH group and 1 (7%) among controls. Mean (SD) duration of hospital stay was 25.0days (24, 9) in TH and 22.5days (20.6) in control patients (P=0.767). Mean (SD) induction period (cooling onset to target temperature) was 126.3min (80.6) with endovascular cooling and 196.3min (76.3) with surface cooling (P=0.025). Conclusions Therapeutic hypothermia with general anaesthesia is feasible in stroke patients. We noticed increased rates of pneumonia, while the length of hospital stay remained comparable. The endovascular cooling strategy provides a faster induction period than surface cooling.},
  author       = {Ovesen, C. and Brizzi, Marco and Pott, F. C. and Thorsen-Meyer, H. C. and Karlsson, Torbjörn and Ersson, Anders and Christensen, H. and Norrlin, A. and Meden, P. and Krieger, D. W. and Petersson, Jesper},
  issn         = {1600-0404},
  keyword      = {stroke,hypothermia,cerebral infarction,ischaemic stroke,acute stroke,therapy},
  language     = {eng},
  number       = {6},
  pages        = {399--405},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Neurologica Scandinavica},
  title        = {Feasibility of endovascular and surface cooling strategies in acute stroke},
  url          = {http://dx.doi.org/10.1111/ane.12059},
  volume       = {127},
  year         = {2013},
}