THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT Volume 1, Number 3, 2011 ª Mary Ann Liebert, Inc. DOI: 10.1089/ther.2011.1505
Editorial
New Therapeutic Strategies Emerge W. Dalton Dietrich, Ph.D.
Dear Colleagues:
T
herapeutic Hypothermia and Temperature Management continues to build momentum as we publish original articles, state-of-the-art reviews, provocative roundtable discussions, and clinical question-and-answer sections that facilitate discussions on the current use of temperature management in the clinical arena. The current issue, our third, highlights several clinical and experimental studies and summaries of recent research topics on the use of these powerful therapeutic strategies to target various patient populations. Two expert panel discussions/ roundtables held at a March 2011 scientific symposium targeting therapeutic hypothermia and temperature management held in Miami will be of great interest to our readers. One discussion targets recent work in the area of Neurological and Neurosurgical ICU units. Questions regarding procedures to induce hypothermia as well as the detrimental effects of cooling in trauma patients are summarized. Acute myocardial infarction is another important clinical problem where therapeutic hypothermia is currently being investigated, and the second panel discussion concentrates on developing clinical trials on acute myocardial infarction and summarizing past and future directions. Several review articles are also highlighted that focused on hypothermia as an adjunct treatment for myocardial infarction by Erlinge et al. Another by Clifton et al. reviews clinical trials of hypothermia treatments for severe traumatic brain injury. Recent studies indicate the possibly that a select subgroup of severely injured TBI patients may benefit from the use of early cooling. An original study by Meloni et al. compares the efficacy of mild and moderate hypothermia alone or in combination with magnesium treatment in a model of global transient ischemia. Hu et al. summarize novel data in regards to the effects of intra-ischemic hypothermia on alterations in NMDA receptor subunits in the CA1 hippocampus. These data may help clarify the reported decrease in vulnerability of this neuronal population to brief periods of hypothermic cerebral ischemia.
Finally, our special Arctic Challenge section of the journal again addresses several important questions currently being asked regarding strategies and risk factors associated with acute and long-term cooling. Topics including approaches to reducing the risk to developing ventilator-associated pneumonias with long-term cooling are discussed. Another question pertains to why patients sustained a large diuresis after the induction of hypothermia. The diagnosis of outcome in patients following cardiac arrest is challenging, and strategies to determine early outcomes are also discussed. The potential benefits and risk factors of a cold saline bolus infusion to normalize or reduce temperature in a patient are discussed. Additionally, other questions including methods to monitor patient’s temperature reliably, warming strategies in cold patients coming into the emergency room, and methods of maintaining normothermia in comatose patients are reviewed. Again, we thank our authors for the submission of highquality manuscripts and for considering this journal as a prime venue to present their new work. The help of our International Editorial Board and reviewers for ensuring quality critiques that enhance the quality of our journal has been invaluable. We are committed to publishing timely manuscripts targeting a variety of basic and clinical questions being addressed in the field of medical treatments. Our plan is to select the best full-length original articles, review articles, and protocols, as well as highly selected case reports for publication. Editorial comments in response to published publications data will be requested from the readership of the journal. As Editor-in-Chief, I hope that you are enjoying the journal. If you have any questions or would like to submit a Letter to the Editor specifically addressing points made in our articles, please contact me. I look forward to your participation in the continued growth of our journal, recognizing these are important times in the journal’s progress and success.
113
—W. Dalton Dietrich, Ph.D. Editor-in-Chief
Editorial
New Therapeutic Strategies Emerge W. Dalton Dietrich, Ph.D.
Dear Colleagues:
T
herapeutic Hypothermia and Temperature Management continues to build momentum as we publish original articles, state-of-the-art reviews, provocative roundtable discussions, and clinical question-and-answer sections that facilitate discussions on the current use of temperature management in the clinical arena. The current issue, our third, highlights several clinical and experimental studies and summaries of recent research topics on the use of these powerful therapeutic strategies to target various patient populations. Two expert panel discussions/ roundtables held at a March 2011 scientific symposium targeting therapeutic hypothermia and temperature management held in Miami will be of great interest to our readers. One discussion targets recent work in the area of Neurological and Neurosurgical ICU units. Questions regarding procedures to induce hypothermia as well as the detrimental effects of cooling in trauma patients are summarized. Acute myocardial infarction is another important clinical problem where therapeutic hypothermia is currently being investigated, and the second panel discussion concentrates on developing clinical trials on acute myocardial infarction and summarizing past and future directions. Several review articles are also highlighted that focused on hypothermia as an adjunct treatment for myocardial infarction by Erlinge et al. Another by Clifton et al. reviews clinical trials of hypothermia treatments for severe traumatic brain injury. Recent studies indicate the possibly that a select subgroup of severely injured TBI patients may benefit from the use of early cooling. An original study by Meloni et al. compares the efficacy of mild and moderate hypothermia alone or in combination with magnesium treatment in a model of global transient ischemia. Hu et al. summarize novel data in regards to the effects of intra-ischemic hypothermia on alterations in NMDA receptor subunits in the CA1 hippocampus. These data may help clarify the reported decrease in vulnerability of this neuronal population to brief periods of hypothermic cerebral ischemia.
Finally, our special Arctic Challenge section of the journal again addresses several important questions currently being asked regarding strategies and risk factors associated with acute and long-term cooling. Topics including approaches to reducing the risk to developing ventilator-associated pneumonias with long-term cooling are discussed. Another question pertains to why patients sustained a large diuresis after the induction of hypothermia. The diagnosis of outcome in patients following cardiac arrest is challenging, and strategies to determine early outcomes are also discussed. The potential benefits and risk factors of a cold saline bolus infusion to normalize or reduce temperature in a patient are discussed. Additionally, other questions including methods to monitor patient’s temperature reliably, warming strategies in cold patients coming into the emergency room, and methods of maintaining normothermia in comatose patients are reviewed. Again, we thank our authors for the submission of highquality manuscripts and for considering this journal as a prime venue to present their new work. The help of our International Editorial Board and reviewers for ensuring quality critiques that enhance the quality of our journal has been invaluable. We are committed to publishing timely manuscripts targeting a variety of basic and clinical questions being addressed in the field of medical treatments. Our plan is to select the best full-length original articles, review articles, and protocols, as well as highly selected case reports for publication. Editorial comments in response to published publications data will be requested from the readership of the journal. As Editor-in-Chief, I hope that you are enjoying the journal. If you have any questions or would like to submit a Letter to the Editor specifically addressing points made in our articles, please contact me. I look forward to your participation in the continued growth of our journal, recognizing these are important times in the journal’s progress and success.
113
—W. Dalton Dietrich, Ph.D. Editor-in-Chief
