All my previous research posts on this for stroke suggested no useful intervention. Obviously no protocols(either positive or negative) were ever written on hypothermia so everyone is still shooting in the dark. The result being that survivors are still screwed with no consequences to the doctors/researchers who haven't written up protocols on this. Don't you just love incompetence?
hypothermia (46 posts to February 2011)
EXPRESS: Therapeutic Hypothermia for Intracerebral Hemorrhage: Systematic Review and Meta-Analysis of the Experimental and Clinical Literature
Abstract
Background
Intracerebral hemorrhage (ICH) remains the deadliest form of stroke worldwide, inducing neuronal death through a wide variety of pathways. Therapeutic hypothermia (TH) is a robust and well studied neuroprotectant widely used across a variety of specialties.
Aims
This review summarizes results from preclinical and clinical studies to highlight the overall effectiveness of TH to improve long-term ICH outcomes while also elucidating optimal protocol regimens to maximize therapeutic effect.
Summary of Review
A systematic review was conducted across three databases to identify trials investigating the use of TH to treat ICH. A random-effects meta-analysis was conducted on preclinical studies, looking at neurobehavioral outcomes, blood brain barrier breakdown (BBB), cerebral edema, hematoma volume, and tissue loss. Several mixed-methods meta-regression models were also performed to adjust for variance and variations in hypothermia induction procedures. 21 preclinical studies and 5 human studies were identified. The meta-analysis of preclinical studies demonstrated a significant benefit in behavioral scores (ES=-0.43, p=0.02), cerebral edema (ES=1.32, p=0.0001), and BBB (ES=2.73, p=<0.00001). TH was not found to significantly affect hematoma expansion (ES=-0.24, p=0.12) or tissue loss (ES=0.06, p=0.68). Clinical study outcome reporting was heterogeneous, however there was recurring evidence of TH-induced edema reduction.
Conclusions
The combined preclinical evidence
demonstrates that TH reduced multiple cell death mechanisms initiated by
ICH, yet there is no definitive evidence in clinical studies. The
cooling strategies employed in both preclinical and clinical studies
were highly diverse, and focused refinement of cooling protocols should
be developed in future preclinical studies. The current data for TH in
ICH remains questionable despite the highly promising indications in
preclinical studies. Definitive randomized controlled studies are still
required to answer this therapeutic question.(So are you bringing this to stroke leadership attention so further research gets done?)
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