Andrea M Kuczynski1, Sina Marzoughi1, Abdulaziz S Al Sultan1, Frederick Colbourne2, Bijoy K Menon1,3, Adriaan C G M van Es4, Aaron L Berez5, Mayank Goyal1,6, Andrew M Demchuk1,3, Mohammed A Almekhlafi7,8. 1. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 2. Department of Psychology, University of Alberta, Edmonton, AB, Canada. 3. Department of Clinical Neurosciences, Hotchkiss Brain Institute, Calgary, AB, Canada. 4. Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands. 5. Alembic, LLC, Mountain View, CA, 94043, USA. 6. Department of Radiology, University of Calgary, Calgary, AB, Canada. 7. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. mohammed.almekhlafi1@ucalgary.ca. 8. Department of Clinical Neurosciences, Hotchkiss Brain Institute, Calgary, AB, Canada. mohammed.almekhlafi1@ucalgary.ca.
Abstract
PURPOSE OF REVIEW: Therapeutic hypothermia (TH) in stroke demonstrates robust neuroprotection in animals but clinical applications remain controversial. We assessed current literature on the efficacy of TH in ischemic stroke. RECENT FINDINGS: We conducted a meta-analysis comparing TH versus controls in studies published until June 2019. Controlled studies reporting on ≥ 10 adults with acute ischemic stroke were included. Primary outcome was functional independence (modified Rankin Scale [mRS] ≤ 2). Twelve studies (n = 351 TH, n = 427 controls) were included. Functional independence did not differ between groups (RR 1.17, 95% CI 0.93-1.46, random-effects p = 0.2). Five studies reported individual mRS outcomes and demonstrated a shift toward better outcome with TH (unadjusted cOR 1.57, 95% CI 1.01-2.44, p = 0.05). Overall complications were higher with TH (RR 1.18, 95% CI 1.06-1.32, p < 0.01). We did not observe an overall beneficial effect of TH in this analysis although some studies showed a shift toward better outcome. TH was associated with increased complications.
PURPOSE OF REVIEW: Therapeutic hypothermia (TH) in stroke demonstrates robust neuroprotection in animals but clinical applications remain controversial. We assessed current literature on the efficacy of TH in ischemic stroke. RECENT FINDINGS: We conducted a meta-analysis comparing TH versus controls in studies published until June 2019. Controlled studies reporting on ≥ 10 adults with acute ischemic stroke were included. Primary outcome was functional independence (modified Rankin Scale [mRS] ≤ 2). Twelve studies (n = 351 TH, n = 427 controls) were included. Functional independence did not differ between groups (RR 1.17, 95% CI 0.93-1.46, random-effects p = 0.2). Five studies reported individual mRS outcomes and demonstrated a shift toward better outcome with TH (unadjusted cOR 1.57, 95% CI 1.01-2.44, p = 0.05). Overall complications were higher with TH (RR 1.18, 95% CI 1.06-1.32, p < 0.01). We did not observe an overall beneficial effect of TH in this analysis although some studies showed a shift toward better outcome. TH was associated with increased complications.
Authors: Lin Guo; Huaien Bu; Maojuan Guo; Yue Zhang; Qun Yu; Bin Yu; Xijuan Jiang; Lin Yang Journal: Evid Based Complement Alternat Med Date: 2022-04-16 Impact factor: 2.650
Authors: Lane J Liddle; Christine A Dirks; Brittany A Fedor; Mohammed Almekhlafi; Frederick Colbourne Journal: Front Neurol Date: 2021-01-06 Impact factor: 4.003