Application of mild therapeutic hypothermia on stroke: a systematic review and meta-analysis.

Stroke Research and Treatment
Shaheen E Lakhan, Fabricio Pamplona

Abstract

Background. Stroke occurs due to an interruption in cerebral blood supply affecting neuronal function. Body temperature on hospital admission is an important predictor of clinical outcome. Therapeutic hypothermia is promising in clinical settings for stroke neuroprotection. Methods. MEDLINE/PubMed, CENTRAL, Stroke Center, and ClinicalTrials.gov were systematically searched for hypothermia intervention induced by external or endovascular cooling for acute stroke. NIH Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were the main stroke scales used, and mortality was also reported. A meta-analysis was carried out on stroke severity and mortality. Results. Seven parallel-controlled clinical trials were included in the meta-analysis. Sample sizes ranged from 18 to 62 patients, yielding a total of 288. Target temperature (∼33°C) was reached within 3-4 hours. Stroke severity (Cohen's d = -0.17, 95% CI: -0.42 to 0.08, P = 0.32; I(2) = 73%; Chi(2) = 21.89, P = 0.0001) and mortality (RR = 1.60, 95% CI: 0.93 to 2.78, P = 0.11; I(2) = 0%; Chi(2) = 2.88, P = 0.72) were not significantly affected by hypothermia. Discussion. Hypothermia does not significantly improve stroke severity; however, this finding should be taken with caution due...Continue Reading

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Citations

Jan 18, 2013·Anesthesiology Research and Practice·Ségolène MrozekThomas Geeraerts
Sep 17, 2013·Journal of Neural Transmission·Mar Hernández-GuillamonJoan Montaner
Jul 16, 2014·Therapeutic Hypothermia and Temperature Management·Faith A BazleyAngelo H All
Sep 23, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yue-Hong WanChao-Yun Huang
Apr 20, 2016·Progress in Neurobiology·Yuan WangGuodong Cao
May 6, 2015·The Journal of Pediatrics·Jorina ElbersCatherine Amlie-Lefond
Mar 1, 2014·ISRN Neurology·Arshad Majid
Jul 28, 2013·Brain Research Bulletin·Thomas I NathanielAdebobola I Nathaniel
Jan 11, 2014·Progress in Neurobiology·Fan ChenXunming Ji
Feb 1, 2018·Acute and Critical Care·Tae Jung Kim, Sang-Bae Ko
Mar 1, 2017·Current Treatment Options in Neurology·Jonathan Marehbian, David M Greer

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Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.