Background and Purpose-We conducted this randomized controlled trial to investigate the effects of therapeutic hypothermia on mortality and neurological outcome in patients with massive cerebral hemispheric infarction. Methods-Patients within 48 hours of symptom onset were randomized to either a hypothermia group or a control group. Patients in the hypothermia group were given standard medical treatment plus endovascular hypothermia with a target temperature of 33 or 34 degrees C. Hypothermia was maintained for a minimum of 24 hours. Patients in the control group were given standard medical treatment only with a target temperature of normothermia. The primary end points were mortality and the modified Rankin Scale score at 6 months. Results-There were 16 patients in the hypothermia group and 17 patients in the control group. At 6 months, 8 patients had died in the hypothermia group versus 7 patients in the control group (P=0.732). The main cause of death was fatal herniation caused by a pronounced rise in intracranial pressure. Seven patients (43.8%) had a modified Rankin Scale of 1 to 3 in the hypothermia group versus 4 patients (23.5%) in the control group (P=0.282). Additionally, of the survivors, patients in the hypothermia group achieved better neurological outcomes compared with those in the control group (7/8, 87.5% versus 4/10, 40.0%; P=0.066; odds ratio=10.5; 95% confidence interval, 0.9-121.4). Conclusions-Mild hypothermia seems to not reduce mortality in patients with massive cerebral hemispheric infarction but may improve the neurological outcome in survivors. An adequately powered multicenter randomized controlled trial seems warranted.
基金：
the National Key Department of Neurology funded by the National Health and Family Planning Commission of the People’s Republic of China
the National Key Department of Critical Care Medicine funded by the National Health and Family Planning Commission of the People’s Republic of China
第一作者机构：[1]Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.[*1]Department of Neurology, Xuan Wu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, China.
通讯作者：
通讯机构：[*1]Department of Neurology, Xuan Wu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, China.
推荐引用方式(GB/T 7714)：
Yingying Su,Linlin Fan,Yunzhou Zhang,et al.Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction[J].STROKE.2016,47(2):457-463.doi:10.1161/STROKEAHA.115.009789.
APA：
Yingying Su,Linlin Fan,Yunzhou Zhang,Yan Zhang,Hong Ye...&Gang Liu.(2016).Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction.STROKE,47,(2)
MLA：
Yingying Su,et al."Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction".STROKE 47..2(2016):457-463
医学