Original Article
Mild Intraoperative Hypothermia during Surgery for Intracranial Aneurysm
N Engl J Med 2005; 352:135-145January 13, 2005
- Abstract
Background
Surgery for intracranial aneurysm often results in postoperative neurologic deficits. We conducted a randomized trial at 30 centers to determine whether intraoperative cooling during open craniotomy would improve the outcome among patients with acute aneurysmal subarachnoid hemorrhage.
Methods
A total of 1001 patients with a preoperative World Federation of Neurological Surgeons score of I, II, or III (“good-grade patients”), who had had a subarachnoid hemorrhage no more than 14 days before planned surgical aneurysm clipping, were randomly assigned to intraoperative hypothermia (target temperature, 33°C, with the use of surface cooling techniques) or normothermia (target temperature, 36.5°C). Patients were followed closely postoperatively and examined approximately 90 days after surgery, at which time a Glasgow Outcome Score was assigned.
Results
There were no significant differences between the group assigned to intraoperative hypothermia and the group assigned to normothermia in the duration of stay in the intensive care unit, the total length of hospitalization, the rates of death at follow-up (6 percent in both groups), or the destination at discharge (home or another hospital, among surviving patients). At the final follow-up, 329 of 499 patients in the hypothermia group had a Glasgow Outcome Score of 1 (good outcome), as compared with 314 of 501 patients in the normothermia group (66 percent vs. 63 percent; odds ratio, 1.14; 95 percent confidence interval, 0.88 to 1.48; P=0.32). Postoperative bacteremia was more common in the hypothermia group than in the normothermia group (5 percent vs. 3 percent, P=0.05).
Conclusions
Intraoperative hypothermia did not improve the neurologic outcome after craniotomy among good-grade patients with aneurysmal subarachnoid hemorrhage.
Media in This Article
Table 1
Baseline Characteristics of the Patients.Table 2
Characteristics of Intraoperative Care.Article Activity
- Article
New neurologic deficits are common after intracranial vascular surgery and are due to factors such as brain retraction, vessel occlusion, and intraoperative hemorrhage. Thus, there have been many efforts to protect the brain from such insults.1-6 The use of systemic hypothermia as a protective adjunct in neurosurgery was first reported in 19557 but was largely abandoned during the 1970s and 1980s. Interest in this approach was rekindled after the demonstration in the laboratory that the induction of mild hypothermia (a temperature of approximately 33 to 35°C) improved the outcome of ischemic and traumatic insults.8-11 This finding coincided with the use of hypothermia for the treatment of other neurologic disorders, including head trauma, stroke, and cardiac arrest.12-16 However, despite surveys showing that hypothermia is used in over 50 percent of surgical procedures for aneurysms,17 several case series,18-22 and our own pilot trial,23 little information is available concerning the effect of hypothermia on the outcome of neurovascular surgery.
Methods
The Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) was a multicenter, prospective, randomized, partially blinded trial designed to determine, in patients with subarachnoid hemorrhage, whether the use of intraoperative hypothermia (target temperature, 33°C) would result in a better outcome, as measured by the score on the Glasgow Outcome Scale24,25 90 days after surgery, than would the use of normothermia (target temperature, 36.5°C). The protocol was reviewed by the human-studies committee at each participating institution. Written informed consent was obtained from the patients or their legal representatives. All anesthesiologists, neurosurgeons, coordinators, and neurologic assessors were certified by means of written examinations. Before randomization was allowed at a center, hypothermia was induced in two patients to verify the ability of staff members to comply with the study protocols.
Eligibility and Randomization
Eligible patients were at least 18 years of age, were not pregnant, had had a subarachnoid hemorrhage from a radiologically demonstrated intracranial aneurysm within 14 days before surgery, and had a World Federation of Neurological Surgeons score of I, II, or III (“good grade”)26 at the time of enrollment, which was verified on arrival in the operating room. Patients were required to have had a Rankin score of 0 (no neurologic disability) or 1 (mild disability) before hemorrhage.27 Patients were excluded if they had a body-mass index (the weight in kilograms divided by the square of the height in meters) of more than 35, had a cold-related disorder, or had an endotracheal tube in place. Nimodipine was started before or after surgery in all but two patients, one in each group.
A permuted-block scheme was used for randomization, with stratification according to the center and the time between subarachnoid hemorrhage and surgery (0 to 7 days or 8 to 14 days). Less than two hours before the planned start of surgery, patients were evaluated and enrolled by means of a telephone-accessed computer system, which directed the anesthesiologist to use a numbered opaque envelope containing the patient's treatment assignment. The envelope was to be opened only after the induction of anesthesia. If, before induction, eligibility criteria were no longer met (owing, for example, to neurologic deterioration), the envelope was not opened and the patient did not undergo randomization. All study personnel, except the anesthesiologists involved in intraoperative care, were unaware of the patients' treatment assignments.
Anesthesia and Temperature Management
Anesthesia was induced with thiopental or etomidate and maintained with isoflurane or desflurane, fentanyl or remifentanil, and a mix of oxygen and nitrous oxide or of oxygen and air. Standard monitors were used. Other monitors (e.g., those for central venous pressure and evoked potentials) were used according to the preferences at a given center.
Each patient's temperature was monitored in the retrocardiac esophagus (Mon-a-therm Esophageal Stethoscope XL, provided by Tyco Mallinckrodt). After endotracheal intubation and positioning of the patient, the temperature probe was inserted and the patient was covered with a forced-air blanket connected to a heating–cooling unit (PolarAir, provided by Arizant). The use of a circulating water mattress and intravenous cold saline as cooling aids was optional.28 In patients assigned to hypothermia, esophageal temperature was reduced as quickly as possible, without any delay in the progress of surgery. The goal was to achieve a temperature between 32.5 and 33.5°C by the time the first clip was applied. The temperature of patients assigned to normothermia was kept between 36 and 37°C. Thiopental or etomidate was permitted for the purpose of cerebral protection, at the discretion of the operating team; this was typically given in conjunction with temporary vessel occlusion. Other medications (e.g., nondepolarizing relaxants, mannitol, and vasoactive agents) were used as needed.
Rewarming of patients assigned to hypothermia began after the last aneurysm clip had been secured. Patients were extubated when deemed ready by the attending physicians. No effort was made to control postoperative care, but detailed daily records were collected until discharge or for 14 days, whichever came first.
Outcomes
Patients were seen approximately 90 days after surgery by a certified examiner and a neuropsychologist who were unaware of patients' treatment assignments. Patients were assessed by means of the Glasgow Outcome Scale, the Rankin scale, the Barthel index,29 the National Institutes of Health (NIH) Stroke Scale,30 and a battery of neuropsychological examinations. If a patient could not be seen by examiners at the operating center, arrangements were made for him or her to be seen elsewhere by a certified examiner. Twelve patients were interviewed by telephone.
Safety and Protocol Management
A total of 106 predefined adverse events or procedures were monitored. Special attention was paid to events related to neurologic injury, myocardial dysfunction,31 coagulation,32,33 and infection.34 A physician from a nonparticipating institution, who was supplied with information on group assignments but not outcomes, reviewed all intraoperative records. He was empowered to contact participating centers if protocol-compliance issues were identified and to communicate with an unblinded member of the University of Iowa Data Management Center if he noted major problems at a center. This resulted in two centers' being dropped (patient data were retained). Three centers were temporarily restricted from enrolling patients until staff members underwent retraining.
Statistical Analysis
We estimated that the enrollment of 1000 patients would permit the detection of a 10 percent absolute improvement in the fraction of patients with a good outcome, as defined by a score of 1 for the Glasgow Outcome Scale (e.g., 75 percent vs. 65 percent), with a statistical power of 91 percent and a two-sided alpha of 0.05. All data entry and analyses were performed by the Data Management Center at the University of Iowa. Outcomes were analyzed according to the intention-to-treat principle. All analyses were defined before the treatment assignments were revealed. Two planned interim analyses were performed after outcome data had been received for 357 and 655 patients, and the results were reported to the data and safety monitoring board. The interim monitoring method of Lan and DeMets was used with the O'Brien–Fleming spending function for these interim analyses. All results are two-sided, and the P values have not been adjusted for the interim analyses.
Differences between the groups in baseline and intraoperative variables were compared by means of t-tests or the Wilcoxon rank-sum test for interval-scale variables, Fisher's exact tests for two-by-two tables, and the Freeman–Halton extension to the Fisher's exact test for categorical variables with more than two possible outcomes.35 The primary outcome variable was a score of 1 on the Glasgow Outcome Scale (indicating mild or no disability). The rates of good outcomes were compared in the normothermia and hypothermia groups with the use of the Cochran–Mantel–Haenszel statistic with study site and time from subarachnoid hemorrhage to surgery as stratification variables.36 We report adjusted odds ratios and 95 percent confidence intervals for differences between rates. Subgroup analyses of the primary outcome were performed according to the method of Grizzle et al.37 Models included terms for treatment, subgroup, and an interaction between treatment and subgroup.
Results
Between February 2000 and April 2003, 3966 patients underwent aneurysm surgery at 30 participating centers; 2856 had a subarachnoid hemorrhage. A total of 1183 patients were eligible, and 1033 patients were enrolled. Owing to changes in status after enrollment, 32 patients did not undergo randomization, resulting in a total enrollment of 1001 patients. One patient was lost to follow-up, leaving 1000 patients in our efficacy population.
The baseline characteristics of the patients are shown in Table 1Table 1
Baseline Characteristics of the Patients.. There were no significant differences between the groups in any preoperative factors, except that fever (temperature of at least 38.5°C at any time) was more common in the hypothermia group than in the normothermia group (5 percent vs. 2 percent, P=0.005). The median time from subarachnoid hemorrhage to surgery was 2 days; 907 patients underwent surgery 0 to 7 days after hemorrhage, and 93 did so 8 to 14 days after hemorrhage. Ventriculostomy was performed preoperatively in 7 percent of patients in the hypothermia group and 9 percent of patients in the normothermia group.Perioperative Care
Perioperative characteristics are shown in Table 2Table 2
Characteristics of Intraoperative Care.. There were no significant differences between groups except in intraoperative and postoperative temperature (P=0.001), the amount of crystalloid administered (P=0.001), and urinary output (P=0.001). There were no significant differences in operating conditions, the incidence and duration of temporary vessel occlusion, the number of patients with severe intraoperative hemorrhage, or other recorded variables.Postoperative Course
There were no significant differences in the number of adverse events in the early postoperative period (data not shown). Two hours after surgery, the temperature was lower in the hypothermia group (Table 2), and 25 percent of patients in this group remained intubated, as compared with 13 percent of patients in the normothermia group. Ten percent of patients in both groups were intubated 24 hours after surgery. Excluding patients who were still intubated and sedated, 39 percent of patients in the hypothermia group and 42 percent of patients in the normothermia group had an increase from baseline of 4 or more points in the NIH Stroke Scale score when they were examined three to six hours after surgery (there were no significant differences between the groups). These values had decreased to 27 percent and 28 percent, respectively, by 24 hours (again, there were no significant differences between groups). There were no significant differences between the hypothermia group and the normothermia group in the mean (±SD) number of days in the intensive care unit (6±5 for both) or the total duration of hospitalization (16±9 and 16±11 days, respectively). Sixty-one percent of patients in the hypothermia group and 59 percent of those in the normothermia group were discharged directly to their homes. Twenty-four patients in the hypothermia group died in the hospital, as compared with 23 in the normothermia group (P=0.88).
Outcome
The median time to the final outcome assessment was 88 days (10th and 90th percentiles, 72 and 113 days) in both groups. Outcome information is presented in Table 3Table 3
Outcomes. for the 1000 patients with follow-up data. There were no significant differences between the groups in any measure. There were no significant treatment-related differences in outcomes between high- and low-volume centers (data not shown).The interaction between the time to surgery and treatment was significant (P=0.04). In the subgroup in which surgery was performed zero to seven days after subarachnoid hemorrhage, 64 percent of patients in the hypothermia group (289 of 452) were classified as having a good outcome, as compared with 63 percent of patients in the normothermia group (287 of 455; odds ratio, 1.06; 95 percent confidence interval, 0.81 to 1.40). In the subgroup in which surgery was performed 8 to 14 days after subarachnoid hemorrhage, 83 percent of patients in the hypothermia group were classified as having a good outcome, as compared with 61 percent of patients in the normothermia group (39 of 47 vs. 28 of 46; odds ratio, 2.70; 95 percent confidence interval, 1.00 to 7.30). However, the difference was no longer significant when outcomes were adjusted for differences in factors present before randomization (smoking status, presence or absence of alcohol abuse, and the incidence of Fisher grade III on computed tomography) between the subgroups.
The interaction between sex and treatment was also significant (P=0.03). In the hypothermia group, 120 of 174 men had a good outcome, as compared with 97 of 171 men in the normothermia group (69 percent vs. 57 percent; odds ratio, 1.78; 95 percent confidence interval, 1.12 to 2.84). However, like the interaction between the time to surgery and treatment assignment, this difference disappeared after adjustment for covariates (in particular, age). Among women, 209 of 325 patients in the hypothermia group had a good outcome, as compared with 217 of 330 in the normothermia group (64.3 percent vs. 65.8 percent); this difference was not significant. Increasing age, increasing World Federation of Neurological Surgeons scores at baseline, increasing Fisher grade at baseline, severe intraoperative hemorrhage, and placement of a temporary clip for at least 20 minutes were associated with worse outcomes, but without any temperature-related interactions.
Outcomes According to Compliance with the Protocol
We expected that the assigned temperatures would not be achieved in some patients. We therefore compared the outcomes in patients whose intraoperative temperatures reached the defined target range of no more than 33.5°C in the hypothermia group (373 patients) and at least 36°C in the normothermia group (467 patients). There were no significant differences between the groups.
Adverse Events
There were no significant differences in the incidence of any event after randomization, except for a higher rate of bacteremia in the hypothermia group than in the normothermia group (25 patients [5 percent] vs. 13 patients [3 percent], P=0.05) (Table 4Table 4
Selected Adverse Events and Procedures.).Discussion
Studies in animals have demonstrated the protective or therapeutic value of mild hypothermia for insults including global cerebral ischemia, permanent or temporary focal ischemia, trauma, and subarachnoid hemorrhage.8-11,38-42 Accordingly, we wished to evaluate hypothermia for the purpose of improving the outcome of neurosurgery. Patients undergoing a craniotomy for the placement of aneurysm clips after subarachnoid hemorrhage seemed to be the optimal study population, since a substantial fraction of such patients awaken with new or worsened neurologic deficits. For example, a review of data on the 2922 surgical patients in the International Study on the Timing of Aneurysm Surgery indicated that 32.5 percent had a decline in neurologic status 24 hours after surgery (Torner J: unpublished data). These values are very similar to the incidence of worsened values on the NIH Stroke Scale 3 to 6 hours and 24 hours postoperatively in our patients.
Although subarachnoid hemorrhage alone damages the brain, neurosurgery carries its own risks. In patients with unruptured aneurysms who were neurologically normal before surgery, the combined rate of postoperative complications and death in one study was 15.7 percent.43 The causes of such complications are unclear but include brain retraction,44 temporary arterial occlusion,45 intraoperative rupture,46 and other ischemic insults that may be amenable to amelioration by hypothermia.
In our patients, unlike patients with stroke, head trauma, or cardiac arrest, cooling could be instituted before the likely time of injury. On the basis of a pilot study,23 we defined the study population as one in which the chances of demonstrating a benefit appeared to be maximal. Eligibility was restricted to those with World Federation of Neurological Surgeons scores of I, II, or III, because we expected the rates of complications and death to be high among patients with scores of IV or V, regardless of the therapy used. Obese patients were excluded because they are difficult to cool.23 Cooling was restricted to the intraoperative period, because the use of longer periods of hypothermia could increase risk and would limit clinicians' ability to assess patients' neurologic status immediately after surgery. A target temperature of 33°C was chosen as low enough to be potentially protective yet practically achievable with the use of surface cooling methods without delaying the progress of surgery.
Our results demonstrate that the use of mild hypothermia in the intraoperative period has no beneficial effects on the outcome in this patient population. The 95 percent confidence intervals for the difference between groups in the percentage of patients with a good outcome rule out the clinically meaningful difference that the trial was designed to detect. We do not think that the observed lack of effect was due to procedural difficulties; the groups were well matched, there was a high degree of compliance with the protocol, and the rate of follow-up was nearly perfect. The lack of effect was also not due to a paucity of surgically related insults, since the neurologic condition was worse in nearly 30 percent of our patients 24 hours after surgery.
There were suggestions of a benefit from hypothermia in two predefined subgroups: patients undergoing surgery 8 to 14 days after subarachnoid hemorrhage and male patients. These findings must be viewed with great caution, since these were secondary analyses. We stratified the analyses according to the time after subarachnoid hemorrhage only to ensure balance between treatment groups; patients did not undergo randomization according to whether surgery was early or late. Delayed surgery was not planned but, rather, was usually the result of delayed referral or diagnosis. The numbers of patients in the normothermia and hypothermia groups who underwent surgery 8 to 14 days after subarachnoid hemorrhage are small (46 and 47 patients, respectively), and randomization did not result in the near-perfect balance in preoperative characteristics seen in the overall study population. The apparent benefit in male patients is subject to the same concerns. Nevertheless, these subgroups may deserve further study.
Our study has limitations. Patients were cooled to approximately 33°C and only for the intraoperative period. The use of colder temperatures for longer periods might have resulted in different outcomes. However, since we saw no differences when we examined only the patients with the coldest temperatures, we do not think that the chosen temperature was critical. It is possible that the relatively slow rate of cooling in our study may have resulted in inadequate protection during the early stage of retractor placement, or exposure of the aneurysm. However, a review of anesthesia records indicated that the temperature of 50 percent of patients in the hypothermia group reached 34.5°C or lower more than an hour before clipping. We controlled esophageal rather than brain temperatures, and there may be discrepancies between these two measurements. However, the patterns of brain and core temperatures are similar,47 and direct measurement of brain temperature during surgery was not deemed practical. We also did not control any aspects of postoperative care. Nevertheless, we were unable to identify any systematic differences in numerous postoperative variables.
We used a relatively crude, albeit widely used outcome assessment. However, we found no significant differences between the groups when other outcome measures were used. (We are still evaluating the outcome on the basis of the results of neuropsychological examinations.) Finally, we included only patients with a relatively good preoperative grade. We recognized that restricting the study to such patients would reduce the incidence of poor outcomes. However, we thought that, given a sufficiently large number of patients, treatment effects, if present, would be detectable. Moreover, the incidence of new or worsened postoperative deficits was high, as was the fraction of patients with outcomes that were less than good. Thus, there is no reason to believe that any clinically meaningful beneficial effects of hypothermia on either the short- or long-term outcome were missed. In summary, we have demonstrated that intraoperative cooling has no overall benefit in this group of neurosurgical patients.
Supported by a grant from the National Institute of Neurological Disease and Stroke (RO1 NS38554).
We are indebted to Professor R. Woolson, Department of Biometry and Epidemiology, Medical University of South Carolina, Charleston (formerly of the University of Iowa); to S. Augustine, former chief executive officer of Augustine Medical; to R. Vosskuhler, former vice president of Clinical Activities, Augustine Medical; to L. Hobright-Turner, former manager of clinical studies, Augustine Medical; and to G. Baldo, product manager of the Temperature Division, Tyco–Mallinckrodt.
Source Information
From the Department of Anesthesia, Roy J. and Lucille A. Carver College of Medicine, University of Iowa (M.M.T., B.J.H.); and the Departments of Biostatistics (W.R.C.) and Epidemiology (J.C.T.) and the Data Management Center (W.R.C.), University of Iowa College of Public Health — both in Iowa City.
Address reprint requests to Dr. Todd at the Department of Anesthesia, University of Iowa, 200 Hawkins Dr., 6546 JCP, Iowa City, IA 52242, or at michael-todd@uiowa.edu.
Participating centers and investigators are listed in the Appendix.
Appendix
The members of IHAST were as follows: University of Iowa — Steering Committee: M. Todd, B. Hindman, W. Clarke, K. Chaloner, J. Torner, P. Davis, M. Howard, D. Tranel, S. Anderson; Clinical Coordinating Center: M. Todd, B. Hindman, J. Weeks, L. Moss, J. Winn; Data Management Center: W. Clarke, K. Chaloner, M. Wichman, R. Peters, M. Hansen, D. Anderson, J. Lang, B. Yoo; Physician Safety Monitor: H. Adams; Project Advisory Committee — G. Clifton (University of Texas, Houston), A. Gelb (University of California, San Francisco), C. Loftus (Temple University, Philadelphia), A. Schubert (Cleveland Clinic, Cleveland); Physician Protocol Monitor — D. Warner (Duke University, Durham, N.C.); Data and Safety Monitoring Board — W. Young, chair (University of California, San Francisco), R. Frankowski (University of Texas Health Science Center at Houston School of Public Health, Houston), K. Kieburtz (University of Rochester School of Medicine and Dentistry, Rochester, N.Y.), D. Prough, University of Texas Medical Branch, Galveston), L. Sternau (Mt. Sinai Medical Center, Miami); NIH, National Institute of Neurological Disease and Stroke, Bethesda, Md. — J. Marler, C. Moy, B. Radziszewska; Participating Centers (the number of randomized patients at each center is listed in parentheses) — Addenbrooke's Hospital, Cambridge, United Kingdom (93): B. Matta, P. Kirkpatrick, D. Chatfield, C. Skilbeck, R. Kirollos, F. Rasulo, K. English, C. Duffy, K. Pedersen, N. Scurrah, R. Burnstein, A. Prabhu, C. Salmond, A. Blackwell, J. Birrell, S. Jackson; University of Virginia Health System, Charlottesville (86): N. Kassell, T. Pajewski, H. Fraley, A. Morris, T. Alden, M. Shaffrey, D. Bogdonoff, M. Durieux, Z. Zuo, K. Littlewood, E. Nemergut, R. Bedford, D. Stone, P. Balestrieri, J. Mason, G. Henry, P. Ting, J. Shafer, T. Blount, L. Kim, A. James, E. Farace, L. Clark, M. Irons, T. Sasaki, K. Webb; Auckland City Hospital, Auckland, New Zealand (69): T. Short, E. Mee, J. Ormrod, J. Jane, T. Alden, P. Heppner, S. Olson, D. Ellegala, C. Lind, J. Sheehan, M. Woodfield, A. Law, M. Harrison, P. Davies, D. Campbell, N. Robertson, R. Fry, D. Sage, S. Laurent, C. Bradfield, K. Pedersen, K. Smith, Y. Young, C. Chambers, B. Hodkinson, J. Biddulph, L. Jensen, J. Ogden, Z. Thayer, F. Lee, S. Crump, J. Quaedackers, A. Wray, V. Roelfsema; Sozialmedizinisches Zentrum Ost–Donauspital, Vienna (58): R. Greif, G. Kleinpeter, C. Lothaller, E. Knosp, W. Pfisterer, R. Schatzer, C. Salem, W. Kutalek, E. Tuerkkan, L. Koller, T. Weber, A. Buchmann, C. Merhaut, M. Graf, B. Rapf; Harborview Medical Center, Seattle (58): A. Lam, D. Newell, P. Tanzi, L. Lee, K. Domino, M. Vavilala, J. Bramhall, M. Souter, G. Britz, H. Winn, H. Bybee; St. Vincent's Public Hospital, Melbourne, Australia (57): T. Costello, M. Murphy, K. Harris, C. Thien, D. Nye, T. Han, P. McNeill, B. O'Brien, J. Cormack, A. Wyss, R. Grauer, R. Popovic, S. Jones, R. Deam, G. Heard, R. Watson, L. Evered, F. Bardenhagen, C. Meade, J. Haartsen, J. Kruger, M. Wilson; University of Iowa Health Care, Iowa City (56): M. Maktabi, V. Traynelis, A. McAllister, P. Leonard, B. Hindman, J. Brian, F. Mensink, R. From, D. Papworth, P. Schmid, D. Dehring, M. Howard, P. Hitchon, J. VanGilder, J. Weeks, L. Moss, K. Manzel, S. Anderson, R. Tack, D. Taggard, P. Lennarson, M. Menhusen; University of Western Ontario, London, Ont., Canada (53): A. Gelb, S. Lownie, R. Craen, T. Novick, G. Ferguson, N. Duggal, J. Findlay, W. Ng, D. Cowie, N. Badner, I. Herrick, H. Smith, G. Heard, R. Peterson, J. Howell, L. Lindsey, L. Carriere, M. von Lewinski, B. Schaefer, D. Bisnaire, P. Doyle-Pettypiece, M. McTaggart; Keck School of Medicine at University of Southern California, Los Angeles (51): S. Giannotta, V. Zelman, E. Thomson, E. Babayan, C. McCleary, D. Fishback; University of Michigan Medical Center, Ann Arbor (41): S. Samra, B. Thompson, W. Chandler, J. Mcgillicuddy, K. Tremper, C. Turner, P. Smythe, E. Dy, S. Pai, V. Portman, J. Palmisano, D. Auer, M. Quigley, B. Giordani, A. Freymuth, P. Scott, R. Silbergleit, S. Hickenbottom; University of California San Francisco, San Francisco (39): L. Litt, M. Lawton, L. Hannegan, D. Gupta, P. Bickler, B. Dodson, P. Talke, I. Rampil, B. Chen, P. Wright, J. Mitchell, S. Ryan, J. Walker, N. Quinnine, C. Applebury; Alfred Hospital, Melbourne, Australia (35): P. Myles, J. Rosenfeld, J. Hunt, S. Wallace, P. D'Urso, C. Thien, J. McMahon, S. Wadanamby, K. Siu, G. Malham, J. Laidlaw, S. Salerno, S. Alatakis, H. Madder, S. Cairo, A. Konstantatos, J. Smart, D. Lindholm, D. Bain, H. Machlin, J. Moloney, M. Buckland, A. Silvers, G. Downey, A. Molnar, M. Langley, D. McIlroy, D. Daly, P. Bennett, L. Forlano, R. Testa, W. Burnett, F. Johnson, M. Angliss, H. Fletcher; Toronto Western Hospital, University Health Network, Toronto (32): P. Manninen, M. Wallace, K. Lukitto, M. Tymianski, P. Porter, F. Gentili, H. El-Beheiry, M. Mosa, P. Mak, M. Balki, S. Shaikh, R. Sawyer, K. Quader, R. Chelliah, P. Berklayd, N. Merah, G. Ghazali, M. McAndrews, J. Ridgley, O. Odukoya, S. Yantha; Wake Forest University Baptist Medical Center, Winston-Salem, N.C. (31): J. Wilson, P. Petrozza, C. Miller, K. O'Brien, C. Tong, M. Olympio, J. Reynolds, D. Colonna, S. Glazier, S. Nobles, D. Hill, H. Hulbert, W. Jenkins; Mayo Clinic College of Medicine, Rochester, Minn. (28): W. Lanier, D. Piepgras, R. Wilson, F. Meyer, J. Atkinson, M. Link, M. Weglinski, K. Berge, D. McGregor, M. Trenerry, G. Smith, J. Walkes, M. Felmlee-Devine; Westfälische Wilhelms-Universitat Muenster, Muenster, Germany (27): H. Van Aken, C. Greiner, H. Freise, H. Brors, K. Hahnenkamp, N. Monteiro de Oliveira, C. Schul, D. Moskopp, C. Greiner, J. Woelfer, C. Hoenemann, H. Gramke, H. Bone, I. Gibmeier, S. Wirtz, H. Lohmann, J. Freyhoff, B. Bauer; University of Wisconsin Clinical Science Center, Madison (26): K. Hogan, R. Dempsey, D. Rusy, B. Badie, B. Iskandar, D. Resnick, P. Deshmukh, J. Fitzpatrick, F. Sasse, T. Broderick, K. Willmann, L. Connery, J. Kish, C. Weasler, N. Page, B. Hermann, J. Jones, D. Dulli, H. Stanko, M. Geraghty, R. Elbe; Montreal Neurological Hospital, Montreal (24): F. Salevsky, R. Leblanc, N. Lapointe, H. Macgregor, D. Sinclair, D. Sirhan, M. Maleki, M. Abou-Madi, D. Chartrand, M. Angle, D. Milovan, Y. Painchaud; Johns Hopkins Medical Institutions, Baltimore (23): M. Mirski, R. Tamargo, S. Rice, A. Olivi, D. Kim, D. Rigamonti, N. Naff, M. Hemstreet, L. Berkow, P. Chery, J. Ulatowski, L. Moore, T. Cunningham, N. McBee, T. Hartman, J. Heidler, A. Hillis, E. Tuffiash, C. Chase, A. Kane, D. Greene-Chandos, M. Torbey, W. Ziai, K. Lane, A. Bhardwaj, N. Subhas; Cleveland Clinic Foundation, Cleveland (20): A. Schubert, M. Mayberg, M. Beven, P. Rasmussen, H. Woo, S. Bhatia, Z. Ebrahim, M. Lotto, F. Vasarhelyi, J. Munis, K. Graves, J. Woletz, G. Chelune, S. Samples, J. Evans, D. Blair, A. Abou-Chebl, F. Shutway, D. Manke, C. Beven; New York Presbyterian Hospital–Weill Medical College of Cornell University, New York (15): P. Fogarty-Mack, P. Stieg, R. Eliazo, P. Li, H. Riina, C. Lien, L. Ravdin, J. Wang, Y. Kuo; Stanford University Medical Center, Palo Alto, Calif. (15): R. Jaffe, G. Steinberg, D. Luu, S. Chang, R. Giffard, H. Lemmens, R. Morgan, A. Mathur, M. Angst, A. Meyer, H. Yi, P. Karzmark, T. Bell-Stephens, M. Marcellus; Plymouth Hospitals National Health Service Trust, Plymouth, United Kingdom (14): J. Sneyd, L. Pobereskin, S. Salsbury, P. Whitfield, R. Sawyer, A. Dashfield, R. Struthers, P. Davies, A. Rushton, V. Petty, S. Harding, E. Richardson; University of Pittsburgh Medical Center, Pittsburgh (11): H. Yonas, F. Gyulai, L. Kirby, A. Kassam, N. Bircher, L. Meng, J. Krugh, G. Seever, R. Hendrickson, J. Gebel; Austin Health, Melbourne, Australia (10): D. Cowie, G. Fabinyi, S. Poustie, G. Davis, A. Drnda, D. Chandrasekara, J. Sturm, T. Phan, A. Shelton, M. Clausen, S. Micallef; Methodist University Hospital, Memphis, Tenn. (8): A. Sills, F. Steinman, P. Sutton, J. Sanders, D. Van Alstine, D. Leggett, E. Cunningham, W. Hamm, B. Frankel, J. Sorenson, L. Atkins, A. Redmond, S. Dalrymple; University of Alabama at Birmingham, Birmingham (7): S. Black, W. Fisher, C. Hall, D. Wilhite, T. Moore II, P. Blanton, Z. Sha; University of Texas Houston Health Science Center, Houston (7): P. Szmuk, D. Kim, A. Ashtari, C. Hagberg, M. Matuszczak, A. Shahen, O. Moise, D. Novy, R. Govindaraj; University of Colorado Health Science Center, Denver (4): L. Jameson, R. Breeze, I. Awad, R. Mattison, T. Anderson, L. Salvia, M. Mosier; University of Oklahoma Health Science Center, Oklahoma City (3): C. Loftus, J. Smith, W. Lilley, B. White, M. Lenaerts.
- References
References
1
Bendtsen AO ,Cold GE ,Astrup J ,Rosenorn J . Thiopental loading during controlled hypotension for intracranial aneurysm surgery. Acta Anesthesiol Scand 1984;28:473-477
CrossRef | Web of Science | Medline2
Batjer HH ,Frankfurt AI ,Purdy PD ,Smith SS ,Samson DS . Use of etomidate, temporary arterial occlusion, and intraoperative angiography in surgical treatment of large and giant cerebral aneurysms. J Neurosurg 1988;68:234-240
CrossRef | Web of Science | Medline3
McDermott MW ,Durity FA ,Borozny M ,Mountain MA . Temporary vessel occlusion and barbiturate protection in cerebral aneurysm surgery. Neurosurgery 1989;25:54-62
CrossRef | Web of Science | Medline4
Ravussin P ,de Tribolet N . Total intravenous anesthesia with propofol for burst suppression in cerebral aneurysm surgery: preliminary report of 42 patients. Neurosurgery 1993;32:236-240
CrossRef | Web of Science | Medline5
Olgilvy CS ,Carter BS ,Kaplan S ,Rich C ,Crowell RM . Temporary vessel occlusion for aneurysm surgery: risk factors for stroke in patients protected by induced hypothermia and hypertension and intravenous mannitol administration. J Neurosurg 1996;84:785-791
CrossRef | Web of Science | Medline6
Cheng MA ,Theard MA ,Tempelhoff R . Intravenous agents and intraoperative neuroprotection: beyond barbiturates. Crit Care Clin 1997;13:185-199
CrossRef | Web of Science | Medline7
Loughheed WM ,Sweet WH ,White JC ,Brewster WR . The use of hypothermia in surgical treatment of cerebral vascular lesions: a preliminary report. J Neurosurg 1955;12:240-255
CrossRef | Web of Science | Medline8
Minamisawa H ,Nordstrom CH ,Smith ML ,Siesjo BK . The influence of mild body and brain hypothermia on ischemic brain damage. J Cereb Blood Flow Metab 1990;10:365-374
CrossRef | Web of Science | Medline9
Dietrich WD ,Busto R ,Valdes I ,Loor Y . Effects of normothermic versus mild hyperthermic forebrain ischemia in rats. Stroke 1990;21:1318-1325
CrossRef | Web of Science | Medline10
Minamisawa H ,Smith ML ,Siesjo BK . The effect of mild hyperthermia and hypothermia on brain damage following 5, 10, and 15 minutes of forebrain ischemia. Ann Neurol 1990;28:26-33
CrossRef | Web of Science | Medline11
Clifton GL ,Jiang JY ,Lyeth BG ,Jenkins LW ,Hamm RJ ,Hayes RL . Marked protection by moderate hypothermia after experimental traumatic brain injury. J Cereb Blood Flow Metab 1991;11:114-121
CrossRef | Web of Science | Medline12
Marion DW ,Penrod LE ,Kelsey SF , et al. Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 1997;336:540-546
Full Text | Web of Science | Medline13
Clifton GL ,Miller ER ,Choi SC , et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001;344:556-563
Full Text | Web of Science | Medline14
Krieger DW ,De Georgia MA ,Abou-Chebl A , et al. Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke. Stroke 2001;32:1847-1854
CrossRef | Web of Science | Medline15
The Hypothermia after Cardiac Arrest Study Group
Full Text | Web of Science | Medline16
Bernard SA ,Gray TW ,Buist MD , et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557-563
Full Text | Web of Science | Medline17
Pemberton PL ,Dinsmore J . The use of hypothermia as a method of neuroprotection during neurosurgical procedures and after traumatic brain injury: a survey of clinical practices in Great Britain and Ireland. Anaesthesia 2003;58:379-373
CrossRef18
Clifton GL ,Christensen ML . Use of moderate hypothermia during elective craniotomy. Tex Med 1992;88:66-69
Medline19
Baker KZ ,Young WL ,Stone JG ,Kader A ,Baker CJ ,Solomon RA . Deliberate mild intraoperative hypothermia for craniotomy. Anesthesiology 1994;81:361-367
CrossRef | Web of Science | Medline20
Sato K ,Sato K ,Yoshimoto T . Systemic and cerebral haemodynamics during craniotomy under mild hypothermia in patients with acute subarachnoid haemorrhage. Acta Neurochir (Wien) 2000;142:1013-1019
CrossRef | Web of Science | Medline21
Kettner SC ,Sitzwohl C ,Zimpfer M , et al. The effect of graded hypothermia (36 degrees C-32 degrees C) on hemostasis in anesthetized patients without surgical trauma. Anesth Analg 2003;96:1772-1776
CrossRef | Web of Science | Medline22
Iwata T ,Inoue S ,Kawaguchi M , et al. Comparison of the effects of sevoflurane and propofol on cooling and rewarming during deliberate mild hypothermia for neurosurgery. Br J Anaesth 2003;90:32-38
CrossRef | Web of Science | Medline23
Hindman BJ ,Todd MM ,Gelb AW , et al. Mild hypothermia as a protective therapy during intracranial aneurysm surgery: a randomized prospective pilot trial. Neurosurgery 1999;44:23-32
CrossRef | Web of Science | Medline24
Jennett B ,Bond M . Assessment of outcome after severe brain damage. Lancet 1975;1:480-484
CrossRef | Web of Science | Medline25
Low molecular weight heparinoid, ORG 10172 (danaparoid), and outcome after acute ischemic stroke: a randomized controlled trial. JAMA 1998;279:1256-1272
26
Drake CG . Report of World Federation of Neurological Surgeons committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg 1988;68:985-986
Web of Science | Medline27
Rankin J . Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scott Med J 1957;2:200-215
Medline28
Baumgardner JE ,Baranov D ,Smith DS ,Zager EL . The effectiveness of rapidly infused intravenous fluids for inducing moderate hypothermia in neurosurgical patients. Anesth Analg 1999;89:163-169
CrossRef | Web of Science | Medline29
Mahoney FI ,Barthel DW . Functional evaluation: the Barthel Index. Md State Med J 1965;14:61-65
Medline30
Wityk RJ ,Pessin MS ,Kaplan RF ,Caplan LR . Serial assessment of acute stroke using the NIH Stroke Scale. Stroke 1994;25:362-365[Erratum, Stroke 1994;25:1300.]
CrossRef | Web of Science | Medline31
Frank SM ,Fleisher LA ,Breslow MJ , et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: a randomized clinical trial. JAMA 1997;277:1127-1134
CrossRef | Web of Science | Medline32
Rohrer MJ ,Natale AM . Effect of hypothermia on the coagulation cascade. Crit Care Med 1992;20:1402-1405
CrossRef | Web of Science | Medline33
Schmied H ,Kurz A ,Sessler DI ,Kozek S ,Reiter A . Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996;347:289-292
CrossRef | Web of Science | Medline34
Kurz A ,Sessler DI ,Lenhardt R . Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996;334:1209-1215
Full Text | Web of Science | Medline35
Freeman GH ,Halton JH . Note on an exact treatment of contingency, goodness of fit and other problems of significance. Biometrika 1951;38:141-149
Web of Science | Medline36
Mantel N ,Haenszel W . Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959;22:719-748
Web of Science | Medline37
Grizzle JE ,Starmer CF ,Koch GG . Analysis of categorical data by linear models. Biometrics 1969;25:489-504
CrossRef | Web of Science | Medline38
Baker CJ ,Onesti ST ,Solomon RA . Reduction by delayed hypothermia of cerebral infarction following middle cerebral artery occlusion in the rat: a time-course study. J Neurosurg 1992;77:438-444
CrossRef | Web of Science | Medline39
Zhang RL ,Chopp M ,Chen H ,Garcia JH ,Zhang ZG . Postischemic (1 hour) hypothermia significantly reduces ischemic cell damage in rats subjected to 2 hours of middle cerebral artery occlusion. Stroke 1993;24:1235-1240
CrossRef | Web of Science | Medline40
Kawai N ,Okauchi M ,Morisaki K ,Nagao S . Effects of delayed intraischemic and postischemic hypothermia on a focal model of transient cerebral ischemia in rats. Stroke 2000;31:1982-1989
CrossRef | Web of Science | Medline41
Piepgras A ,Elste V ,Frietsch T ,Schmiedek P ,Reith W ,Schilling L . Effect of moderate hypothermia on experimental severe subarachnoid hemorrhage, as evaluated by apparent diffusion coefficient changes. Neurosurgery 2001;48:1128-1135
CrossRef | Web of Science | Medline42
Ridenour TR ,Warner DS ,Todd MM ,McAllister AC . Mild hypothermia reduces infarct size resulting from temporary but not permanent focal ischemia in rats. Stroke 1992;23:733-738
CrossRef | Web of Science | Medline43
International Study of Unruptured Intracranial Aneurysms Investigators
Full Text | Web of Science | Medline44
Andrews RJ ,Bringas JR . A review of brain retraction and recommendations for minimizing intraoperative brain injury. Neurosurgery 1993;33:1052-1064
CrossRef | Web of Science | Medline45
Samson D ,Batjer HH ,Bowman G , et al. A clinical study of the parameters and effects of temporary arterial occlusion in the management of intracranial aneurysms. Neurosurgery 1994;34:22-28
CrossRef | Web of Science | Medline46
Fridriksson S ,Saveland H ,Jakobsson K-E , et al. Intraoperative complications in aneurysm surgery: a prospective national study. J Neurosurg 2002;96:515-522
CrossRef | Web of Science | Medline47
Mellergard P ,Nordstrom CH . Intracerebral temperature in neurosurgical patients. Neurosurgery 1991;28:709-713
CrossRef | Web of Science | Medline
- Citing Articles (132)
Citing Articles
1
Luying Ryan Li, Chao You, Bhuwan Chaudhary, Chao You. 2012. Intraoperative mild hypothermia for postoperative neurological deficits in intracranial aneurysm patients. .
CrossRef2
Christina Miller, Marek Mirski. (2012) Anesthesia Considerations and Intraoperative Monitoring During Surgery for Arteriovenous Malformations and Dural Arteriovenous Fistulas. Neurosurgery Clinics of North America 23:1, 153-164
CrossRef3
Hilary P. Grocott, Adam Andreiw. (2012) Con: Topical Head Cooling Should Not Be Used During Deep Hypothermic Circulatory Arrest. Journal of Cardiothoracic and Vascular Anesthesia
CrossRef4
Daniel E. Warren, Philip E. Bickler, John P. Clark, Maren Gregersen, Heather Brosnan, Will McKleroy, Pablo Gabatto. (2012) Hypothermia and rewarming injury in hippocampal neurons involves intracellular Ca 2+ and glutamate excitotoxicity. Neuroscience
CrossRef5
Shoji Yokobori, Janek Frantzen, Ross Bullock, Shyam Gajavelli, Stephen Burks, Helen Bramlett, W. Dalton Dietrich. (2011) The Use of Hypothermia Therapy in Traumatic Ischemic/Reperfusional Brain Injury: Review of the Literatures. Therapeutic Hypothermia and Temperature Management 1:4, 185-192
CrossRef6
K. F. J. Ng, C. W. Cheung, Y. Lee, S. W. S. Leung. (2011) Low-dose desmopressin improves hypothermia-induced impairment of primary haemostasis in healthy volunteers*. Anaesthesia 66:11, 999-1005
CrossRef7
Wilson Roberto Oliveira Milani, Pedro L Antibas, Gilmar F Prado, Wilson Roberto Oliveira Milani. 2011. Cooling for cerebral protection during brain surgery. .
CrossRef8
, Giuseppe Lanzino, Pietro Ivo D’Urso, Jose Suarez. (2011) Seizures and Anticonvulsants after Aneurysmal Subarachnoid Hemorrhage. Neurocritical Care 15:2, 247-256
CrossRef9
Elizabeth M. Moore, Alistair D. Nichol, Stephen A. Bernard, Rinaldo Bellomo. (2011) Therapeutic hypothermia: Benefits, mechanisms and potential clinical applications in neurological, cardiac and kidney injury. Injury 42:9, 843-854
CrossRef10
Edited by Mary Kay Bader. (2011) Clinical Q & A: Translating Therapeutic Temperature Management from Theory to Practice. Therapeutic Hypothermia and Temperature Management 1:2, 107-112
CrossRef11
Mark E. Nunnally, Roman Jaeschke, Geoffrey J. Bellingan, Jacques Lacroix, Bruno Mourvillier, Gloria M. Rodriguez-Vega, Sten Rubertsson, Theodoros Vassilakopoulos, Craig Weinert, Sergio Zanotti-Cavazzoni, Timothy G. Buchman. (2011) Targeted temperature management in critical care: A report and recommendations from five professional societies*. Critical Care Medicine 39:5, 1113-1125
CrossRef12
Kelly B. Mahaney, Michael M. Todd, James C. Torner. (2011) Variation of patient characteristics, management, and outcome with timing of surgery for aneurysmal subarachnoid hemorrhage. Journal of Neurosurgery 114:4, 1045-1053
CrossRef13
&NA;. (2011) Perioperative Hypothermia (33°C) Does Not Increase the Occurrence of Cardiovascular Events in Patients Undergoing Cerebral Aneurysm Surgery. Survey of Anesthesiology 55:2, 77-78
CrossRef14
Diederik O. Bulters, Thomas Santarius, H. Ling Chia, Richard A. Parker, Rikin Trivedi, Peter J. Kirkpatrick, Ramez W. Kirollos. (2011) Causes of neurological deficits following clipping of 200 consecutive ruptured aneurysms in patients with good-grade aneurysmal subarachnoid haemorrhage. Acta Neurochirurgica 153:2, 295-303
CrossRef15
Monica S. Vavilala, Sulpicio G. Soriano. 2011. Anesthesia for Neurosurgery. , 713-744.
CrossRef16
Harold P. Adams. 2011. Clinical Scales to Assess Patients with Stroke. , 307-333.
CrossRef17
Jennifer Diedler, Marek Sykora, Werner Hacke. 2011. Critical Care of the Patient with Acute Stroke. , 1008-1048.
CrossRef18
Lun Li, TianTian Sun, KeHu Yang, Peng Zhang, Wen Qin Jia, KeHu Yang. 2010. Monoclonal CCR5 antibody for treatment of people with HIV infection. .
CrossRef19
K. M. Erickson, D. J. Cole. (2010) Carotid artery disease: stenting vs endarterectomy. British Journal of Anaesthesia 105:Supplement 1, i34-i49
CrossRef20
Istvan Miko, Robert Gould, Scott Wolf, Sherif Afifi. (2010) Acute Spinal Cord Injury. International Anesthesiology Clinics 47:1, 37-54
CrossRef21
Yu Hua, Kenjiro Hisano, Yuji Morimoto. (2010) Effect of mild and moderate hypothermia on hypoxic injury in nearly pure neuronal culture. Journal of Anesthesia 24:5, 726-732
CrossRef22
Jeffrey J Pasternak, William L Lanier. (2010) Is nitrous oxide use appropriate in neurosurgical and neurologically at-risk patients?. Current Opinion in Anaesthesiology 23:5, 544-550
CrossRef23
Adnan I. Qureshi, Nauman Tariq, Gabriela Vazquez, Jill Novitzke, M. Fareed K. Suri, Kamakshi Lakshminarayan, Stephen J. Haines. (2010) Low Patient Enrollment Sites in Multicenter Randomized Clinical Trials of Cerebrovascular Diseases: Associated Factors and Impact on Trial Outcomes. Journal of Stroke and Cerebrovascular Diseases
CrossRef24
Hoang P. Nguyen, Jonathan G. Zaroff, Emine O. Bayman, Adrian W. Gelb, Michael M. Todd, Bradley J. Hindman. (2010) Perioperative Hypothermia (33°C) Does Not Increase the Occurrence of Cardiovascular Events in Patients Undergoing Cerebral Aneurysm Surgery. Anesthesiology 113:2, 327-342
CrossRef25
John F. Bebawy, Dhanesh K. Gupta, Bernard R. Bendok, Laura B. Hemmer, Carine Zeeni, Michael J. Avram, H. Hunt Batjer, Antoun Koht. (2010) Adenosine-Induced Flow Arrest to Facilitate Intracranial Aneurysm Clip Ligation. Anesthesia & Analgesia 110:5, 1406-1411
CrossRef26
Luying Ryan Li, Chao You, Bhuwan Chaudhary, Chao You. 2010. Intraoperative mild hypothermia for postoperative neurological deficits in intracranial aneurysm patients. .
CrossRef27
Jeffrey J. Pasternak, William L. Lanier. (2010) Neuroanesthesiology Update. Journal of Neurosurgical Anesthesiology 22:2, 86-109
CrossRef28
Tatsuya ISHIKAWA. (2010) What is the Role of Clipping Surgery for Ruptured Cerebral Aneurysms in the Endovascular Era? A Review of Recent Technical Advances and Problems to be Solved. Neurologia medico-chirurgica 50:9, 800-808
CrossRef29
Jean Mantz, Vincent Degos, Christophe Laigle. (2010) Recent advances in pharmacologic neuroprotection. European Journal of Anaesthesiology 27:1, 6-10
CrossRef30
Bradley J. Hindman, Emine O. Bayman, Wolfgang K. Pfisterer, James C. Torner, Michael M. Todd. (2010) No Association between Intraoperative Hypothermia or Supplemental Protective Drug and Neurologic Outcomes in Patients Undergoing Temporary Clipping during Cerebral Aneurysm Surgery. Anesthesiology 112:1, 86-101
CrossRef31
Xian N. Tang, Midori A. Yenari. (2010) Hypothermia as a cytoprotective strategy in ischemic tissue injury. Ageing Research Reviews 9:1, 61-68
CrossRef32
Ryogo ANEI, Hideki SAKAI, Koji IIHARA, Izumi NAGATA. (2010) Effectiveness of Brain Hypothermia Treatment in Patients With Severe Subarachnoid Hemorrhage — Comparisons at a Single Facility. Neurologia medico-chirurgica 50:10, 879-883
CrossRef33
Hing-Yu So. (2010) Therapeutic hypothermia. Korean Journal of Anesthesiology 59:5, 299
CrossRef34
Stefan Moritz, Jan Warnat, Sylvia Bele, Bernhard Martin Graf, Chris Woertgen. (2010) The Prognostic Value of NSE and S100B From Serum and Cerebrospinal Fluid in Patients With Spontaneous Subarachnoid Hemorrhage. Journal of Neurosurgical Anesthesiology 22:1, 21-31
CrossRef35
&NA;. (2009) Effect of Nitrous Oxide Use on Long-Term Neurologic and Neuropsychological Outcome in Patients Who Received Temporary Proximal Artery Occlusion During Cerebral Aneurysm Clipping Surgery. Survey of Anesthesiology 53:6, 256-257
CrossRef36
Hidetoshi Wakamatsu, Tomohiko Utsuki. (2009) Development of a basic air-cooling fuzzy control system for hypothermia. Artificial Life and Robotics 14:3, 311-317
CrossRef37
Irina Lasarzik, Uta Winkelheide, Serge C. Thal, Natascha Benz, Matthias Lörscher, Antje Jahn-Eimermacher, Christian Werner, Kristin Engelhard. (2009) Mild Hypothermia Has No Long-Term Impact on Postischemic Neurogenesis in Rats. Anesthesia & Analgesia 109:5, 1632-1639
CrossRef38
F. Hildebrand, C. Probst, M. Frink, S. Huber-Wagner, C. Krettek. (2009) Bedeutung der Hypothermie beim Polytrauma. Der Unfallchirurg 112:11, 959-964
CrossRef39
Robert D. Stevens, Neeraj S. Naval, Marek A. Mirski, Giuseppe Citerio, Peter J. Andrews. (2009) Intensive care of aneurysmal subarachnoid hemorrhage: an international survey. Intensive Care Medicine 35:9, 1556-1566
CrossRef40
Rainer Lenhardt, Mukadder Orhan-Sungur, Ryu Komatsu, Raghavendra Govinda, Yusuke Kasuya, Daniel I. Sessler, Anupama Wadhwa. (2009) Suppression of Shivering during Hypothermia Using a Novel Drug Combination in Healthy Volunteers. Anesthesiology 111:1, 110-115
CrossRef41
Daniel I. Sessler. (2009) Thermoregulatory defense mechanisms. Critical Care Medicine 37:Supplement, S203-S210
CrossRef42
Guillermo Linares, Stephan A. Mayer. (2009) Hypothermia for the treatment of ischemic and hemorrhagic stroke. Critical Care Medicine 37:Supplement, S243-S249
CrossRef43
M. Krishnaswamy, M. Westcott, R. Huilgol. (2009) Carotid-Vertebral Artery Bypass for Symptomatic Vertebral Artery Pseudoaneurysm. EJVES Extra 17:6, 58-60
CrossRef44
Takayuki Oku, Masami Fujii, Nobuhiro Tanaka, Hirochika Imoto, Joji Uchiyama, Fumiaki Oka, Ichiro Kunitsugu, Hiroshi Fujioka, Sadahiro Nomura, Koji Kajiwara, Hirosuke Fujisawa, Shoichi Kato, Takashi Saito, Michiyasu Suzuki. (2009) The influence of focal brain cooling on neurophysiopathology: validation for clinical application. Journal of Neurosurgery 110:6, 1209-1217
CrossRef45
Raymond Choi, Robert H. Andres, Gary K. Steinberg, Raphael Guzman. (2009) Intraoperative hypothermia during vascular neurosurgical procedures. Neurosurgical FOCUS 26:5, E24
CrossRef46
Michael M. Todd, Bradley J. Hindman, William R. Clarke, James C. Torner, Julie B. Weeks, Emine O. Bayman, Qian Shi, Christina M. Spofford. (2009) PERIOPERATIVE FEVER AND OUTCOME IN SURGICAL PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE. Neurosurgery 64:5, 897-909
CrossRef47
Jeffrey J. Pasternak, William L. Lanier. (2009) Neuroanesthesiology Update. Journal of Neurosurgical Anesthesiology 21:2, 73-97
CrossRef48
Donald Marion, M. Ross Bullock. (2009) Current and Future Role of Therapeutic Hypothermia. Journal of Neurotrauma 26:3, 455-467
CrossRef49
Federico Bilotta, Remo Caramia, Francesca P. Paoloni, Roberto Delfini, Giovanni Rosa. (2009) Safety and Efficacy of Intensive Insulin Therapy in Critical Neurosurgical Patients. Anesthesiology 110:3, 611-619
CrossRef50
Crystal L. MacLellan, Darren L. Clark, Gergely Silasi, Frederick Colbourne. (2009) Use of Prolonged Hypothermia to Treat Ischemic and Hemorrhagic Stroke. Journal of Neurotrauma 26:3, 313-323
CrossRef51
Jeffrey J. Pasternak, Diana G. McGregor, William L. Lanier, Darrell R. Schroeder, Deborah A. Rusy, Bradley Hindman, William Clarke, James Torner, Michael M. Todd. (2009) Effect of Nitrous Oxide Use on Long-term Neurologic and Neuropsychological Outcome in Patients Who Received Temporary Proximal Artery Occlusion during Cerebral Aneurysm Clipping Surgery. Anesthesiology 110:3, 563-573
CrossRef52
G. Burkhard Mackensen, David L. McDonagh, David S. Warner. (2009) Perioperative Hypothermia: Use and Therapeutic Implications. Journal of Neurotrauma 26:3, 342-358
CrossRef53
Martin A. Seule, Carl Muroi, Susanne Mink, Yasuhiro Yonekawa, Emanuela Keller. (2009) THERAPEUTIC HYPOTHERMIA IN PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE, REFRACTORY INTRACRANIAL HYPERTENSION, OR CEREBRAL VASOSPASM. Neurosurgery 64:1, 86-93
CrossRef54
Gunn Hee Kim, Yang Hoon Chung, Myung Hee Kim, Ik Soo Chung, Jeong Jin Lee. (2009) The comparison of complications on the endovascular and surgical treatment in elderly cerebral aneurysm patients. Korean Journal of Anesthesiology 57:4, 460
CrossRef55
Hidetada Fukushima, Kenji Nishio, Kazuo Okuchi. (2009) Subarachnoid Hemorrhage Associated with Ventricular Fibrillation and Out-of-Hospital Cardiac Arrest. Case Reports in Medicine 2009, 1-3
CrossRef56
Sang-Bae Ko. (2009) General Management of Acute Stroke. Journal of the Korean Medical Association 52:4, 334
CrossRef57
Kiyotaka SATO, Masato KATO. (2009) Brain Protection with Hypothermia. THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 29:4, 352-357
CrossRef58
Emine Ãzgür Bayman, Kathryn Chaloner, Mary Kathryn Cowles. (2009) Detecting qualitative interaction: A Bayesian approach. Statistics in Medicinen/a-n/a
CrossRef59
&NA;. (2008) Effect of Nitrous Oxide on Neurologic and Neuropsychological Function After Intracranial Aneurysm Surgery. Survey of Anesthesiology 52:6, 287-288
CrossRef60
Erik F. Hauck, Jingna Wei, Michael J. Quast, Haring J. W. Nauta. (2008) A new technique allowing prolonged temporary cerebral artery occlusion. Journal of Neurosurgery 109:6, 1127-1133
CrossRef61
Brian K. Kwon, Cody Mann, Hong Moon Sohn, Alan S. Hilibrand, Frank M. Phillips, Jeffrey C. Wang, Michael G. Fehlings. (2008) Hypothermia for spinal cord injury. The Spine Journal 8:6, 859-874
CrossRef62
R. G. HOFF, G. W. VAN DIJK, S. METTES, B. H. VERWEIJ, A. ALGRA, G. J. E. RINKEL, C. J. KALKMAN. (2008) Hypotension in anaesthetized patients during aneurysm clipping: not as bad as expected?. Acta Anaesthesiologica Scandinavica 52:7, 1006-1011
CrossRef63
Lars Peter Wang, Michael James Paech. (2008) Neuroanesthesia for the Pregnant Woman. Anesthesia & Analgesia 107:1, 193-200
CrossRef64
Kees H Polderman. (2008) Induced hypothermia and fever control for prevention and treatment of neurological injuries. The Lancet 371:9628, 1955-1969
CrossRef65
Katja E Wartenberg, Stephan A Mayer. (2008) Use of induced hypothermia for neuroprotection: indications and application. Future Neurology 3:3, 325-361
CrossRef66
Yekaterina K. Axelrod, Michael N. Diringer. (2008) Temperature Management in Acute Neurologic Disorders. Neurologic Clinics 26:2, 585-603
CrossRef67
J. Diedler, M. Köhrmann, P. Vajkoczy, T. Steiner. (2008) Behandlung schwerster Schlaganfälle auf der Intensivstation. Notfall + Rettungsmedizin 11:3, 183-189
CrossRef68
Diana G. McGregor, William L. Lanier, Jeffrey J. Pasternak, Deborah A. Rusy, Kirk Hogan, Satwant Samra, Bradley Hindman, Michael M. Todd, Darrell R. Schroeder, Emine Ozgur Bayman, William Clarke, James Torner, Julie Weeks. (2008) Effect of Nitrous Oxide on Neurologic and Neuropsychological Function after Intracranial Aneurysm Surgery. Anesthesiology 108:4, 568-579
CrossRef69
Irene Rozet. (2008) Methylprednisolone in Acute Spinal Cord Injury. Journal of Neurosurgical Anesthesiology 20:2, 137-139
CrossRef70
Deborah J. Culley, Gregory Crosby. (2008) Nitrous Oxide in Neuroanesthesia. Anesthesiology 108:4, 553-554
CrossRef71
Jeffrey J. Pasternak, William L. Lanier. (2008) Neuroanesthesiology Review—2007. Journal of Neurosurgical Anesthesiology 20:2, 78-104
CrossRef72
J. J. Pasternak, D. G. McGregor, D. R. Schroeder, W. L. Lanier, Q. Shi, B. J. Hindman, W. R. Clarke, J. C. Torner, J. B. Weeks, M. M. Todd, . (2008) Hyperglycemia in Patients Undergoing Cerebral Aneurysm Surgery: Its Association With Long-term Gross Neurologic and Neuropsychological Function. Mayo Clinic Proceedings 83:4, 406-417
CrossRef73
G.S. Umamaheswara Rao, M. Radhakrishnan. (2008) Significant but suboptimal?. Journal of Clinical Neuroscience 15:3, 333
CrossRef74
Andrea Kurz. (2008) Thermal care in the perioperative period. Best Practice & Research Clinical Anaesthesiology 22:1, 39-62
CrossRef75
Ricardo J. Komotar, Brad E. Zacharia, J Mocco, E. Sander Connolly. (2008) CONTROVERSIES IN THE SURGICAL TREATMENT OF RUPTURED INTRACRANIAL ANEURYSMS. Neurosurgery 62:2, 396-407
CrossRef76
Sung-Moon Jeong, Kyung-Don Hahm, Yong-Bo Jeong, Hong-Seuk Yang, In-Cheol Choi. (2008) Warming of Intravenous Fluids Prevents Hypothermia During Off-Pump Coronary Artery Bypass Graft Surgery. Journal of Cardiothoracic and Vascular Anesthesia 22:1, 67-70
CrossRef77
Daniel L. Surdell, Ziad A. Hage, Christopher S. Eddleman, Dhanesh K. Gupta, Bernard R. Bendok, H. Hunt Batjer. (2008) Revascularization for complex intracranial aneurysms. Neurosurgical FOCUS 24:2, E21
CrossRef78
Masahiko KAWAGUCHI, Hitoshi FURUYA. (2008) Strategies for Brain and Spinal Cord Protection in Neuroanesthesia: Importance of Technique and Anesthetic Management in Neuromonitoring. THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 28:4, 543-551
CrossRef79
Daniel I Sessler. (2008) Whatʼs Hot in Thermoregulation. ASA Refresher Courses in Anesthesiology 36:1, 155-166
CrossRef80
Robert E. Hoesch, Romergryko G. Geocadin. (2007) Therapeutic Hypothermia for Global and Focal Ischemic Brain Injury—A Cool Way to Improve Neurologic Outcomes. The Neurologist 13:6, 331-342
CrossRef81
Venkatesh Aiyagari, Michael N. Diringer. (2007) Fever control and its impact on outcomes: What is the evidence?. Journal of the Neurological Sciences 261:1-2, 39-46
CrossRef82
Robert D. Stevens, Paul A. Nyquist. (2007) The systemic implications of aneurysmal subarachnoid hemorrhage. Journal of the Neurological Sciences 261:1-2, 143-156
CrossRef83
Martin Smith. (2007) Intensive care management of patients with subarachnoid haemorrhage. Current Opinion in Anaesthesiology 20:5, 400-407
CrossRef84
F. Bach, F. Mertzlufft. (2007) Klinische Möglichkeiten zur Steuerung der Körpertemperatur. Der Anaesthesist 56:9, 917-922
CrossRef85
Enrique C. Leira, Patricia H. Davis, Coleman O. Martin, James C. Torner, Bongin Yoo, Julie B. Weeks, Bradley J. Hindman, Michael M. Todd. (2007) IMPROVING PREDICTION OF OUTCOME IN “GOOD GRADE” SUBARACHNOID HEMORRHAGE. Neurosurgery 61:3, 470-474
CrossRef86
Scott A. LeGrand, Bradley J. Hindman, Franklin Dexter, Linda G. Moss, Michael M. Todd. (2007) Reliability of a Telephone-Based Glasgow Outcome Scale Assessment Using a Structured Interview in a Heterogenous Population of Patients and Examiners. Journal of Neurotrauma 24:9, 1437-1446
CrossRef87
Wilson Roberto Oliveira Milani, Gilmar Fernandes do Prado, Humberto Saconato, Pedro L. Antibas, Wilson Roberto Oliveira Milani. 2007. Cooling for cerebral protection for brain surgery. .
CrossRef88
Federico Bilotta, Adrian W Gelb, Sulpicio G Soriano, Qiaoheng Wang, Francesca P Paoloni, Giovanni Rosa, Federico Bilotta. 2007. Pharmacologic therapies for perioperative cerebral protection against neurologic or neurocognitive deficits. .
CrossRef89
Jeffrey J. Pasternak, William L. Lanier. (2007) Neuroanesthesiology Review-2006. Journal of Neurosurgical Anesthesiology 19:2, 70-92
CrossRef90
F. Bach, F. Mertzlufft. (2007) Therapeutische Hypothermie und Säure-Basen-Management. Der Anaesthesist 56:4, 366-370
CrossRef91
T.G. Costello, R.D. Thomas, L. Hong. (2007) IHAST II and the response of neuroanaesthetists. Journal of Clinical Neuroscience 14:4, 322-327
CrossRef92
Elizabeth A. M. Frost. (2007) Handbook of Neuroanesthesia, 4th ed.. Anesthesia & Analgesia 104:3, 750-751
CrossRef93
Vikram Jadhav, Ihsan Solaroglu, Andre Obenaus, John H. Zhang. (2007) Neuroprotection against surgically induced brain injury. Surgical Neurology 67:1, 15-20
CrossRef94
Philip E. Bickler, Piyush M. Patel. (2007) Anesthetic Neuroprotection. Anesthesiology 106:1, 8-10
CrossRef95
Anna Levati, Concezione Tommasino, Maria Pia Moretti, Roberto Paino, Giuseppe D??Aliberti, Francesco Santoro, Stefania Meregalli, Sergio Vesconi, Massimo Collice. (2007) Giant Intracranial Aneurysms Treated With Deep Hypothermia and Circulatory Arrest. Journal of Neurosurgical Anesthesiology 19:1, 25-30
CrossRef96
Takehiko SASAKI, Toshiaki OSATO, Kazuyuki HAYASE, Kenji KAMIYAMA, Toshiichi WATANABE, Hirohiko NAKAMURA. (2007) Surgery of Recurrent Intracranial Aneurysms after Neck Clipping. Surgery for Cerebral Stroke 35:1, 47-51
CrossRef97
Toru GOYAGI. (2007) Neuroprotection. THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 27:7, 588-598
CrossRef98
A.E. Goetz. (2006) Kontrollierte Hypothermie. Der Anaesthesist 55:12, 1245-1246
CrossRef99
Christian A. Helland, Jostein Kr??kenes, Gunnar Moen, Knut Wester. (2006) A POPULATION-BASED STUDY OF NEUROSURGICAL AND ENDOVASCULAR TREATMENT OF RUPTURED, INTRACRANIAL ANEURYSMS IN A SMALL NEUROSURGICAL UNIT. Neurosurgery 59:6, 1168???1176
CrossRef100
E. Clarke Haley. (2006) Measuring cognitive outcome after subarachnoid hemorrhage. Annals of Neurology 60:5, 502-504
CrossRef101
Steven W. Anderson, Michael M. Todd, Bradley J. Hindman, William R. Clarke, James C. Torner, Daniel Tranel, Bongin Yoo, Julie Weeks, Kenneth W. Manzel, Satwant Samra, . (2006) Effects of intraoperative hypothermia on neuropsychological outcomes after intracranial aneurysm surgery. Annals of Neurology 60:5, 518-527
CrossRef102
W. Scott Jellish. (2006) Anesthetic Issues and Perioperative Blood Pressure Management in Patients Who Have Cerebrovascular Diseases Undergoing Surgical Procedures. Neurologic Clinics 24:4, 647-659
CrossRef103
Tarja Randell, Minna Niskanen. (2006) Management of physiological variables in neuroanaesthesia: maintaining homeostasis during intracranial surgery. Current Opinion in Anaesthesiology 19:5, 492-497
CrossRef104
Ramachandran Ramani. (2006) Hypothermia for brain protection and resuscitation. Current Opinion in Anaesthesiology 19:5, 487-491
CrossRef105
A Deogaonkar, M De Georgia, E Mascha, M Todd, A Schubert. (2006) Intraoperative Blood Loss is Associated with Worse Outcome after Aneurysmal Subarachnoid Hemorrhage. Journal of Neurosurgical Anesthesiology 18:4, 302-303
CrossRef106
Y AXELROD, M DIRINGER. (2006) Temperature Management in Acute Neurologic Disorders. Critical Care Clinics 22:4, 767-785
CrossRef107
Claus U. Niemann, Soojinna Choi, Matthias Behrends, Ryutaro Hirose, Joonhwa Noh, John L. Coatney, John P. Roberts, Natalie J. Serkova, Jacquelyn J. Maher. (2006) Mild hypothermia protects obese rats from fulminant hepatic necrosis induced by ischemia-reperfusion. Surgery 140:3, 404-412
CrossRef108
Jose I. Suarez. (2006) Outcome in neurocritical care: Advances in monitoring and treatment and effect of a specialized neurocritical care team. Critical Care Medicine 34:Suppl, S232-S238
CrossRef109
J SUAREZ. (2006) Treatment of ruptured cerebral aneurysms and vasospasm after subarachnoid hemorrhage. Neurosurgery Clinics of North America 17, 57-69
CrossRef110
David L. McDonagh, Idi N. Allen, John C. Keifer, David S. Warner. (2006) Induction of Hypothermia After Intraoperative Hypoxic Brain Insult. Anesthesia & Analgesia 103:1, 180-181
CrossRef111
A. J. Gunn, M. Thoresen. (2006) Hypothermic neuroprotection. NeuroRX 3:2, 154-169
CrossRef112
Jeffrey J. Pasternak, William L. Lanier. (2006) Neuroanesthesiology Review???2005. Journal of Neurosurgical Anesthesiology 18:2, 93-105
CrossRef113
Neeraj S. Naval, Robert D. Stevens, Marek A. Mirski, Anish Bhardwaj. (2006) Controversies in the management of aneurysmal subarachnoid hemorrhage*. Critical Care Medicine 34:2, 511-524
CrossRef114
Suarez, Jose I., Tarr, Robert W., Selman, Warren R., . (2006) Aneurysmal Subarachnoid Hemorrhage. New England Journal of Medicine 354:4, 387-396
Full Text115
Masato Iwata, Masahiko Kawaguchi, Satoki Inoue, Masahiro Takahashi, Toshinori Horiuchi, Toshisuke Sakaki, Hitoshi Furuya. (2006) Effects of Increasing Concentrations of Propofol on Jugular Venous Bulb Oxygen Saturation in Neurosurgical Patients under Normothermic and Mildly Hypothermic Conditions. Anesthesiology 104:1, 33-38
CrossRef116
A. J. Gunn, M. Thoresen. (2006) Hypothermic neuroprotection. Neurotherapeutics 3:2, 154
CrossRef117
Masahiko KAWAGUCHI, Hitoshi FURUYA. (2006) Skills Required in Anesthetic Management of Neurosurgery. THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 26:4, 347-352
CrossRef118
Michael S. Avidan. (2006) Perioperative Bugs, Prions, and Virions. ASA Refresher Courses in Anesthesiology 34:1, 21-29
CrossRef119
Katsuzo KIYA, Hideki SATOH, Tatsuya MIZOUE, Shinya NABIKA, Yosuke KAJIHARA, Hiroshi KONDO. (2006) Surgical Approach for Cerebral Aneurysm Study in Efficacy of Mild Hypothermia for Cerebral Ischemia Resulted from Temporary Arterial Occlusion During Aneurysm Surgery. Surgery for Cerebral Stroke 34:5, 347-351
CrossRef120
A VERMA. (2006) Mild Intraoperative Hypothermia During Surgery for Intracranial AneurysmTodd MM, for the Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) Investigators (Univ of Iowa, Iowa City; et al) N Engl J Med 352:135–145, 2005§. Yearbook of Neurology and Neurosurgery 2006, 8-9
CrossRef121
Akiko Taguchi, Andrea Kurz. (2005) Thermal management of the patient: where does the patient lose and/or gain temperature?. Current Opinion in Anaesthesiology 18:6, 632-639
CrossRef122
Dean A Cowie. (2005) The role of hypothermia in neurosurgical patients. Current Opinion in Anaesthesiology 18:5, 496-500
CrossRef123
McGregor DG, Lanier WL, Rusy DA, Hogan K, Samra S, Hindman BJ, Todd MM, Pasternak JJ, Schroeder DR, Clarke WR, Torner JC. (2005) Effect of Nitrous Oxide on Neurologic Function Following Intracranial Aneurysm Surgery. Journal of Neurosurgical Anesthesiology 17:4, 239
CrossRef124
Chanhung Z Lee, William L Young. (2005) Management of brain arteriovenous malformations. Current Opinion in Anaesthesiology 18:5, 484-489
CrossRef125
Serge C Thal, Kristin Engelhard, Christian Werner. (2005) New cerebral protection strategies. Current Opinion in Anaesthesiology 18:5, 490-495
CrossRef126
M. Arango, C. Niño, J. Mejia-Mantilla. (2005) Survey of neuroanaesthesia practice patterns in Colombia. European Journal of Anaesthesiology 22:Supplement 36, 3
CrossRef127
M. Arango, C. Niño, J. Mejia-Mantilla. (2005) Survey of neuroanaesthesia practice patterns in Colombia. European Journal of Anaesthesiology 22:Supplement 36, 14-15
CrossRef128
Andrew J Molyneux, Richard SC Kerr, Ly-Mee Yu, Mike Clarke, Mary Sneade, Julia A Yarnold, Peter Sandercock. (2005) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. The Lancet 366:9488, 809-817
CrossRef129
Sang-Bum Hong, Younsuck Koh, In-Chul Lee, Mi Joung Kim, Woo Sung Kim, Dong-Soon Kim, Won Dong Kim, Chae-Man Lim. (2005) Induced hypothermia as a new approach to lung rest for the acutely injured lung*. Critical Care Medicine 33:9, 2049-2055
CrossRef130
Arthur R. H. van Zanten, Kees H. Polderman. (2005) Early induction of hypothermia: Will sooner be better?*. Critical Care Medicine 33:6, 1449-1452
CrossRef131
Gunther J Pestel, Andrea Kurz. (2005) Hypothermia – itʼs more than a toy. Current Opinion in Anaesthesiology 18:2, 151-156
CrossRef132
Ellegala, Dilantha B., Day, Arthur L., . (2005) Ruptured Cerebral Aneurysms. New England Journal of Medicine 352:2, 121-124
Full Text
