Journal article
No association between intraoperative hypothermia or supplemental protective drug and neurologic outcomes in patients undergoing temporary clipping during cerebral aneurysm surgery: findings from the Intraoperative Hypothermia for Aneurysm Surgery Trial
Anesthesiology (Philadelphia), Vol.112(1), pp.86-101
01/2010
DOI: 10.1097/ALN.0b013e3181c5e28f
PMID: 19952722
Abstract
Although hypothermia and barbiturates improve neurologic outcomes in animal temporary focal ischemia models, the clinical efficacy of these interventions during temporary occlusion of the cerebral vasculature during intracranial aneurysm surgery (temporary clipping) is not established.
A post hoc analysis of patients from the Intraoperative Hypothermia for Aneurysm Surgery Trial who underwent temporary clipping was performed. Univariate and multivariate logistic regression methods were used to test for associations between hypothermia, supplemental protective drug, and short- (24-h) and long-term (3-month) neurologic outcomes. An odds ratio more than 1 denotes better outcome.
Patients undergoing temporary clipping (n = 441) were assigned to intraoperative hypothermia (33.3 degrees +/- 0.8 degrees C, n = 208) or normothermia (36.7 degrees +/- 0.5 degrees C, n = 233), with 178 patients also receiving supplemental protective drug (thiopental or etomidate) during temporary clipping. Three months after surgery, 278 patients (63%) had good outcome (Glasgow Outcome Score = 1). Neither hypothermia (P = 0.847; odds ratio = 1.043, 95% CI = 0.678-1.606) nor supplemental protective drug (P = 0.835; odds ratio = 1.048, 95% CI = 0.674-1.631) were associated with 3-month Glasgow Outcome Score. The effect of supplemental protective drug did not significantly vary with temperature. The effects of hypothermia and protective drug did not significantly vary with temporary clip duration. Similar findings were made for 24-h neurologic status and 3-month Neuropsychological Composite Score.
In the Intraoperative Hypothermia for Aneurysm Surgery Trial, neither systemic hypothermia nor supplemental protective drug affected short- or long-term neurologic outcomes of patients undergoing temporary clipping.
Details
- Title: Subtitle
- No association between intraoperative hypothermia or supplemental protective drug and neurologic outcomes in patients undergoing temporary clipping during cerebral aneurysm surgery: findings from the Intraoperative Hypothermia for Aneurysm Surgery Trial
- Creators
- Bradley J Hindman - Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA. brad-hindman@uiowa.eduEmine O BaymanWolfgang K PfistererJames C TornerMichael M ToddIHAST Investigators
- Resource Type
- Journal article
- Publication Details
- Anesthesiology (Philadelphia), Vol.112(1), pp.86-101
- DOI
- 10.1097/ALN.0b013e3181c5e28f
- PMID
- 19952722
- NLM abbreviation
- Anesthesiology
- ISSN
- 0003-3022
- eISSN
- 1528-1175
- Publisher
- United States
- Grant note
- R01 NS38554 / NINDS NIH HHS
- Language
- English
- Date published
- 01/2010
- Academic Unit
- Epidemiology; Biostatistics; Surgery; Anesthesia; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995046002771
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