Craniocerebral hypothermia in the acute period of ischemic stroke

Gutsalyuk A.G.

Eramishantsev City Clinical Hospital

ORCID: 0000-0001-9599-5933

Petrova M.V.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0003-4272-0957

Borozenets K.F.

Eramishantsev City Clinical Hospital

ORCID: 0009-0000-1594-4926

Shevelev O.A.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0002-6204-1110

Grechko A.V.

Negovsky Research Institute of Intensive Care

ORCID: 0000-0003-3318-796X

Mengistu E.M.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0002-6928-2320

Tsentsiper L.M.

Almazov National Medical Research Centre

ORCID: 0000-0001-7527-7707

Semerchev D.P.

Eramishantsev City Clinical Hospital

ORCID: 0009-0007-4707-2588

Kolbaskina I.N.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0009-0000-2804-8952

Mirilashvili N.T.

Eramishantsev City Clinical Hospital

ORCID: 0009-0001-0096-6564

Craniocerebral hypothermia in the acute period of ischemic stroke

Authors:

Gutsalyuk A.G., Petrova M.V., Borozenets K.F., Shevelev O.A., Grechko A.V., Mengistu E.M., Tsentsiper L.M., Semerchev D.P., Kolbaskina I.N., Mirilashvili N.T.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(12‑2): 43‑48

DOI: 10.17116/jnevro202312312243

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To cite this article:

Gutsalyuk AG, Petrova MV, Borozenets KF, et al. . Craniocerebral hypothermia in the acute period of ischemic stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(12‑2):43‑48. (In Russ.)
https://doi.org/10.17116/jnevro202312312243

Подписка 2025 (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

Использование инфографики авторами научных работ

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OBJECTIVE

To determine the effect of craniocerebral hypothermia (CCH) on neurological deficit regression, hemodynamics, fever and functional outcome of therapy in patients with moderate ischemic stroke (IS).

MATERIAL AND METHODS

This study included 60 patients with IS (the first day). The main group consisted of 30 patients who underwent CCH, and the comparison (control) group consisted of 30 patients without CCH. The National Institutes of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRs) were used. Recorded parameters were mortality, heart rate (HR), blood pressure (BP), axial temperature, cerebral temperature of the frontal cortex. Cerebral temperature was obtained noninvasively by using a RTM-01-RES radiothermometer (Russia). CCH (for 24 hours) in the main group was implemented by ATG-01 device (Russia). Results were recorded on the day of admission, after 24 hours and at discharge. In both groups, basic neuroprotective, hypotensive, antiplatelet and antiedemic therapy was administered.

RESULTS

No fatal outcomes were reported in both groups. Side-effects and complications of CCH were not recorded. In the main group, neurological deficit assessed by NIHSS decreased by 75% after the CCH procedure and by 93.75% at the time of discharge from the hospital. In patients of the comparison group, regression of neurological deficit was 35% on the second day and 55% at the day of discharge. The use of CCH suppressed systemic and cerebral hyperthermia. Functional outcome of therapy in the main group was higher compared to the comparison one. The dynamics in blood pressure and heart rate didn’t differ in both groups.

CONCLUSION

A pronounced positive effect of CCH on the course of the acute period and therapy results in patients with IS was demonstrated.

Keywords:

ischemic stroke

craniocerebral hypothermia

cerebral hyperthermia

Authors:

Gutsalyuk A.G.

Eramishantsev City Clinical Hospital

ORCID: 0000-0001-9599-5933

Petrova M.V.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0003-4272-0957

Borozenets K.F.

Eramishantsev City Clinical Hospital

ORCID: 0009-0000-1594-4926

Shevelev O.A.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0002-6204-1110

Grechko A.V.

Negovsky Research Institute of Intensive Care

ORCID: 0000-0003-3318-796X

Mengistu E.M.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0000-0002-6928-2320

Tsentsiper L.M.

Almazov National Medical Research Centre

ORCID: 0000-0001-7527-7707

Semerchev D.P.

Eramishantsev City Clinical Hospital

ORCID: 0009-0007-4707-2588

Kolbaskina I.N.

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

ORCID: 0009-0000-2804-8952

Mirilashvili N.T.

Eramishantsev City Clinical Hospital

ORCID: 0009-0001-0096-6564

Received:

25.07.2023

Accepted:

02.10.2023

List of references:

Shevelev OA, Petrova MV, Saidov ShH, et al. Hypothermic preconditioning. Bulletin of Neurology, Psychiatry and Neurosurgery. 2018;11(106):50-60. (In Russ.).
Shevelev OA, Petrova MV, Saidov SK, et al. Neuroprotection Mechanisms in Cerebral Hypothermia (Review). General Reanimatology. 2019;15(6):94-114. (In Russ.). https://doi.org/10.15360/1813-9779-2019-6-94-114
Faridar A, Bershad EM, Emiru T, et al. Therapeutic Hypothermia in Stroke and Traumatic Brain Injury. Frontiers in Neurology. 2011;2(8):34-39. https://doi.org/10.3389/fneur.2011.00080
Broessner G, Fischer M, Lackner P, et al. Complications of hypothermia: infections. Critical Care. 2012;16(suppl 2):A19. https://doi.org/10.1186/cc11277
Vaity C, Al-Subaie N, Cecconi M. Cooling techniques for targeted temperature management post-cardiac arrest. Critical Care. 2015;19(1):103. https://doi.org/10.1186/s13054-015-0804-1
Klinicheskie rekomendatsii «Ishemicheskii insul’t i tranzitornaya ishemicheskaya ataka u vzroslykh» — 2021-2022-2023 (01.09.2021) — Utverzhdeny Minzdravom Rossii. (In Russ.). https://cr.minzdrav.gov.ru/schema/171_2?ysclid=ljgz6g0er2836775803
Saxena M, Young P, Pilcher D, et al. Early temperature and mortality in critically ill patients with acute neurological diseases: trauma and stroke differ from infection. Intensive Care Medicine. 2015;41(5):823-832. https://doi.org/10.1007/s00134-015-3676-6
CastilloJ, DávalosA, Marrugat J, Noya M. Timing for Fever-Related Brain Damage in Acute Ischemic Stroke. Stroke. 1998;29(12):2455-2460. https://doi.org/10.1161/01.str.29.12.2455
Mrozek S, Vardon F, Geeraerts T. Brain Temperature: Physiology and Pathophysiology after Brain Injury. Anesthesiology Research and Practice. 2012;2012:1-13. https://doi.org/10.1155/2012/989487
Shevelev O, Petrova M, Smolensky A, et al. Using medical microwave radiometry for brain temperature measurements. Drug Discovery Today. 2022;27(3):881-889. https://doi.org/10.1016/j.drudis.2021.11.004
Shevelev OA, Petrova MV, Yuriev MYu, et al. Microwave Radiothermometry in Evaluating Brain Temperature Changes (Review). General Reanimatology. 2023;19(1):50-59. (In Russ.). https://doi.org/10.15360/1813-9779-2023-1-2129
Shevelev OA, Grechko AV, Petrova MV, et al. Terapevticheskaya gipotermiya (monografiya). M.: RUDN; 2019: 265. (In Russ.).
Ma W, Liu W, Li M. Analytical heat transfer model for targeted brain hypothermia. International Journal of Thermal Sciences. 2016;100:66-74. https://doi.org/10.1016/j.ijthermalsci.2015.09.014
González-Ibarra FP, Varon J, López-Meza EG. Therapeutic Hypothermia: Critical Review of the Molecular Mechanisms of Action. Frontiers in Neurology. 2011;2(12):23-29. https://doi.org/10.3389/fneur.2011.00004
Sun YJ, Zhang ZY, Fan B, Li GY. Neuroprotection by Therapeutic Hypothermia. Frontiers in Neuroscience. 2019;13:586. https://doi.org/10.3389/fnins.2019.00586
Doberentz E, Markwerth P, Wagner R, Madea B. Expression of Hsp27 and Hsp70 and vacuolization in the pituitary glands in cases of fatal hypothermia. Forensic Science, Medicine and Pathology. 2017;13(3):312-316. https://doi.org/10.1007/s12024-017-9884-3
Rzechorzek NM, Connick P, Patani R, et al. Hypothermic Preconditioning of Human Cortical Neurons Requires Proteostatic Priming. EBioMedicine. 2015;2(6):528-535. https://doi.org/10.1016/j.ebiom.2015.04.004
Shevelev OA, Petrova MV, Mengistu EM, et al. Correction of Local Brain Temperature after Severe Brain Injury Using Hypothermia and Medical Microwave Radiometry (MWR) as Companion Diagnostics. Diagnostics. 2023; 13(6):1159. https://doi.org/10.3390/diagnostics13061159
Petrova MV, Shevelev OA, Yuriev MY, et al. Selective Brain Hypothermia in the Comprehensive Rehabilitation of Patients with Chronic Consciousness Disorders. General Reanimatology. 2022;18(2):45-52. (In Russ.). https://doi.org/10.15360/1813-9779-2022-2-45-52
Boyarintsev VV, Zhuravlev SV, Ardashev VN, et al. Characteristics of cerebral blood flow in the norm and in pathologies in the course of craniocerebral hypothermia. Aerospace and Environmental Medicine. 2019;53(4):59-64. (In Russ.). https://doi.org/10.21687/0233-528X-2019-53-4-59-64
Shevelev OA, Grechko AV, Petrova MV, et al. Gipotermiya golovnogo mozga v terapii tserebral’nykh porazhenii. Teoriya i praktika (monografiya). M.: RUSAINS; 2020;230. (In Russ.).

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