1. Perioperative Hypothermia (33°C) Does Not Increase the Occurrence of Cardiovascular Events in Patients Undergoing Cerebral Aneurysm Surgery
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D. Chartrand, Michael Beven, C. Salem, W. Burnett, S. Jackson, G. Downey, Michael T. Lawton, S. Lownie, R. Tack, E. Dy, Tord D. Alden, David R. McIlroy, Lis Evered, K. Lukitto, L. Kirby, Thomas A. Moore, R. Popovic, N. Robertson, Patrick W. Hitchon, A. Ashtari, R. Elbe, N. F. Kassell, D. Dulli, A. Wyss, G. Ghazali, S. Rice, Gavin W. Britz, P. Bennett, Karen B. Domino, A. Shahen, D. Dehring, Robert Greif, Argye E. Hillis, L. Meng, D. Fishback, Fred Gentili, Mark Buckland, B. Schaefer, H. Madder, C. Weasler, Anish Bhardwaj, E. Thomson, Ramez W. Kirollos, Basil F. Matta, Kevin H. Siu, H. Machlin, W. Pfisterer, A. Freymuth, N. Badner, R. Wilson, R. Grauer, Zhiyi Zuo, A. McAllister, Z. Sha, A. Rushton, D. Hill, William T. Clarke, L. Jensen, G. Heard, L. Clark, D. Chatfield, J. Haartsen, Jing Wang, S. Nobles, Renee Testa, P. D'Urso, Hossam El-Beheiry, David J. Stone, James C. Torner, Michael J. Souter, A. Meyer, Marek A. Mirski, Marlan R. Hansen, W. Jenkins, L. Pobereskin, J. Walkes, M. Quigley, R. Struthers, James H McMahon, Howard A. Riina, Behnam Badie, P. Heppner, Simon Jones, R. Silbergleit, Thomas N. Pajewski, T. Broderick, Katherine Harris, P. Smythe, N. Duggal, J. Quaedackers, J. Mason, P. E. Bickler, P. McNeill, V. Roelfsema, I. Gibmeier, C. Chambers, H. Gramke, D. Campbell, T. Novick, O. Moise, J. Woletz, Lorri A. Lee, H. Van Aken, Adrian W. Gelb, A. Kane, B. Rapf, Martin S. Angst, S. Shaikh, D. Sirhan, C. Miller, B. Hodkinson, D. Leggett, F. Johnson, Harry J. M. Lemmens, M. Langley, Y. Young, Jeffrey V. Rosenfeld, C. Moy, W. Hamm, C. Hall, G. Henry, R. Burnstein, Lisa Hannegan, A. Buchmann, R. Schatzer, Bruce P. Hermann, John E. McGillicuddy, Bruno Giordani, John C. VanGilder, Keith H. Berge, D. Sage, L. Sternau, N. Page, Marc R. Mayberg, B Thompson, T. Hartman, Laurel E. Moore, S. Bhatia, Richard A. Jaffe, G. Seever, D. Cowie, Jonathan G. Zaroff, C. Duffy, Deborah A. Rusy, Elana Farace, H R Winn, Paul H. Ting, R. Spinka, J. Marler, Patricia H. Petrozza, S. Harding, Lauren C. Berkow, E. Cunningham, D. Bisnaire, D. Wilhite, P. Blanton, S. Laurent, O. Odukoya, Issam A. Awad, P. Chery, C. Lind, B. Bauer, D. Lindholm, K. Kieburtz, J. Ormrod, Michael P. Murphy, Timothy G. Short, Y. Painchaud, R. Peters, Peter C. Whitfield, D. Bain, B. Hindman, A. Shelton, A. Morris, D. Milovan, L. Salvia, William L. Young, S. Wallace, W. Lilley, H. Yi, R. Chelliah, David W. Newell, R. Deam, John Laidlaw, P. Mak, J. Woelfer, K. Graves, Peter M. C. Wright, D. Van Alstine, M. Hemstreet, Phillip A. Scott, Steven D. Chang, S. Poustie, M. Clausen, I. Herrick, Daniel H. Kim, Vladimir Zelman, John L.D. Atkinson, Marcel E. Durieux, Alessandro Olivi, G. Smith, James R. Munis, F. Vasarhelyi, S. Olson, C. Greiner, C. Hoenemann, G. Kleinpeter, J. Kish, Daniel K. Resnick, J. Lang, Dhanesh K. Gupta, E. Knosp, N. Monteiro de Oliveira, D. Moskopp, Carin A. Hagberg, J. Howell, Klaus Hahnenkamp, Gregory M. Davis, T. Phan, Paul S. Myles, C. Beven, F. Salevsky, Maria Matuszczak, E. Mee, David L. Bogdonoff, P. Berklayd, J. Freyhoff, P. Tanzi, A. Law, Barbara A. Dodson, Z. Thayer, R. Govindaraj, Alex Konstantatos, Ralph F. Frankowski, Pirjo H. Manninen, David G. Piepgras, K. Willmann, E. Babayan, Donald S. Prough, Leslie C. Jameson, John A. Wilson, Mary Pat McAndrews, M. Abou-Madi, Steven S. Glazier, Vincent C. Traynelis, Derek A. Taggard, Fredric B. Meyer, C. Bradfield, Hoang P. Nguyen, Mary L. Marcellus, J. Ogden, M. Maleki, M. Lotto, Michael A. Olympio, C. Merhaut, D. Nye, K. Webb, Richard Leblanc, Nichol McBee, William L. Lanier, A. Molnar, Peter J. Lennarson, S. Wadanamby, H. Hulbert, Christopher R. Turner, H. Fraley, Kevin K. Tremper, Sesto Cairo, J. Shafer, J. Krugh, D. Blair, L. Coghlan, P. Schmid, K. O'Brien, K. Littlewood, T. Anderson, R. Eliazo, S. Wirtz, Carol B. Applebury, Jennifer O. Hunt, S. Hickenbottom, Hendrik Freise, Gary D. Steinberg, M. Woodfield, Robert J. Dempsey, Kirk J. Hogan, M. Harrison, H. Stanko, Teresa Bell-Stephens, N. Merah, T. Blount, J. Sanders, J. Biddulph, Tsutomu Sasaki, F. Mensink, P. Balestrieri, Lisa D. Ravdin, H. Lohmann, M. Todd, James Gebel, Lawrence Litt, Christoph Schul, B. White, Bradley J. Hindman, S. Salerno, A. James, D. Manke, Mvon Lewinski, D. Luu, Michael M. Todd, A. Drnda, S. Salsbury, J. Palmisano, L. Connery, Michael Tymianski, E. Tuffiash, Cynthia A. Lien, R. Sawyer, A. Sills, D. Sinclair, J. Bramhall, Ira J. Rampil, David M. Colonna, M. Geraghty, Steven W. Anderson, V. Petty, S. Pai, J. Sheehan, S. Black, K. English, N. Scurrah, Diana G. McGregor, P. Davies, P. Doyle-Pettypiece, H. Bone, Neal J. Naff, M. Lenaerts, James Mitchell, K. Pedersen, Matthew A. Howard, M. Angliss, Daniel Tranel, Bongin Yoo, M. Irons, Emine O. Bayman, C. Skilbeck, Nicholas G. Bircher, Wendy C. Ziai, S. Micallef, Chuanyao Tong, Kathryn Chaloner, Mark T. Wallace, John Moloney, Gavin Fabinyi, P. Sutton, Edward C. Nemergut, Elizabeth Richardson, C. McCleary, M. Graf, Mrinalini Balki, P. Porter, James J. Evans, A. Prabhu, L. Kim, R. Hendrickson, A. Dashfield, V. Portman, Michel T. Torbey, J. Kruger, Donna L. Auer, J. Sorenson, Patricia H. Davis, John A. Walker, M. Mosier, H. Smith, J. Heidler, Andrew Silvers, P. Fogarty-Mack, William F. Chandler, F. Shutway, F. Rasulo, S. Alatakis, Stephen Samples, A. Wray, Henry H. Woo, John A. Ulatowski, Steven L. Giannotta, D. Chandrasekara, J. Sturm, S. Crump, Peter A. Rasmussen, Max R. Trenerry, D. Novy, Wink S. Fisher, N. Quinnine, F. Bardenhagen, M. Angle, W. Ng, G. Ferguson, A. Blackwell, Christopher M. Loftus, James H. Fitzpatrick, David S. Warner, E. Tuerkkan, W. Kutalek, Ferenc E. Gyulai, D. Daly, Helen Fletcher, J. Smith, Mazen A. Maktabi, Howard Yonas, J. Sneyd, M. Menhusen, Johnny E. Brian, K. Smith, R. Watson, T. Weber, D. Greene-Chandos, M. Wichman, Peter Szmuk, J. Birrell, Pekka Talke, J. Jane, L. Atkins, J. Smart, T. Han, B. O'Brien, R. Mattison, Bermans J. Iskandar, J. Ridgley, S. Dalrymple, L. Lindsey, D. Anderson, Julie B. Weeks, M. Felmlee-Devine, P. Deshmukh, D. Ellegala, L. Moss, A. Mathur, F. Lee, F. Sasse, H. Macgregor, R. Peterson, Margaret R. Weglinski, Karen Lane, Daniele Rigamonti, L. Carriere, Mark Wilson, R. Morgan, T. Costello, C. Thien, Arthur M. Lam, H. Bybee, C. Salmond, Robert E. Breeze, Peter Karzmark, Monica S. Vavilala, S. Yantha, Philip E. Stieg, Guy L. Clifton, Kenneth Manzel, D. Papworth, Rafael J. Tamargo, Rosemary A. Craen, Harold P. Adams, B. Radziszewska, Y. Kuo, Satwant K. Samra, B. Frankel, R. Fry, T. Cunningham, M. Mosa, M. McTaggart, F. Steinman, Alex Abou-Chebl, Michael J. Link, Rona G. Giffard, N. Lapointe, C. Meade, Robert F. Bedford, J. Cormack, Robert P. From, J. Reynolds, Paul A. Leonard, K. Quader, N. Subhas, C. Lothaller, S. Ryan, J. Winn, H. Brors, Amin B. Kassam, A. Gelb, J. Zaroff, Gregory M. Malham, A. Redmond, Gordon J. Chelune, J. Findlay, Zeyd Ebrahim, L. Forlano, Mark E. Shaffrey, C. Chase, Peter J. Kirkpatrick, Armin Schubert, L. Koller, Jana E. Jones, P. Li, and B. Chen
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medicine.medical_specialty ,Subarachnoid hemorrhage ,Interventional cardiology ,business.industry ,Vascular disease ,Perioperative ,Hypothermia ,medicine.disease ,Preoperative care ,Anesthesiology and Pain Medicine ,Aneurysm ,Anesthesia ,Anesthesiology ,Medicine ,medicine.symptom ,business - Abstract
Background Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. Methods The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3 degrees +/- 0.8 degrees C) or normothermia (n = 501, 36.7 degrees +/- 0.5 degrees C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. Results There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6%) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 microg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 microg/l, P = 0.038). Conclusion In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.
- Published
- 2010
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