title: Cooling Activity is Associated with Neurological Outcome in Patients with Severe Cerebrovascular Disease Undergoing Endovascular Temperature Control.
abstract: BACKGROUND
  Neuroprotection through targeted temperature management is currently investigated in patients with severe brain injury in multiple trials. Feedback devices have been shown to precisely reach and maintain target temperature by constantly adjusting cooling activity. We analyzed the association between cooling activity expressed as cool bath temperatures and functional neurological outcome.
  
  
  METHODS
  Data were retrospectively analyzed from a prospective randomized trial on controlled prophylactic normothermia (i.e., 36.5 °C) in patients with severe cerebrovascular disease. Body core temperature of patients who had been randomized to the endovascular group, was controlled using an endovascular cooling device. Cool bath temperature was analyzed over a period of 168 h. Functional neurological outcome was evaluated at 180 days using the modified Rankin Scale.
  
  
  RESULTS
  51 of 102 patients included were randomized to the endovascular group. Cool bath temperature data were available from 47/51 patients. Patients with lower cool bath temperatures reflecting high cooling activity had a more favorable neurological outcome at 180 days (mRS 0-2) than patients with low cooling activity (p < 0.05). We did not find a significant correlation between cool bath temperature and inflammatory markers.
  
  
  CONCLUSIONS
  High cooling activity of an endovascular feedback device is associated with favorable outcome in patients with severe cerebrovascular disease.
authors.affiliation: Neurocritical Care Unit, Department of Neurology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Marlene
authors.initials: M
authors.lastname: Fischer
authors.forename: Peter
authors.initials: P
authors.lastname: Lackner
authors.forename: Ronny
authors.initials: R
authors.lastname: Beer
authors.forename: Raimund
authors.initials: R
authors.lastname: Helbok
authors.forename: Bettina
authors.initials: B
authors.lastname: Pfausler
authors.forename: Dietmar
authors.initials: D
authors.lastname: Schneider
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
authors.forename: Gregor
authors.initials: G
authors.lastname: Broessner
mesh_terms: D000368:Aged; D001831:Body Temperature / Q000502:physiology*; D002543:Cerebral Hemorrhage / Q000628:therapy*; D002544:Cerebral Infarction / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D013345:Subarachnoid Hemorrhage / Q000628:therapy*