THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT Volume 4, Number 3, 2014 ª Mary Ann Liebert, Inc. DOI: 10.1089/ther.2014.1507
Editorial
Editorial Comment W. Dalton Dietrich, PhD
I
n this issue of Therapeutic Hypothermia and Temperature Management, we provide a number of informative articles that summarize progress in the area of temperature management strategies targeting different types of human disorders. Two expert panel discussions/roundtables held at the 4th Annual Therapeutic Hypothermia and Temperature Management Conference in Miami in 2014 are highlighted. The first discussion summarizes recent work in the area of targeted temperature management after a variety of injuries, including novel temperature management strategies in patients with large burns. The consequences of early cooling to reduce the frequency of post-traumatic epilepsy, as well as the beneficial effects of hypothermia in patients after neonatal encephalopathy, are also discussed. A second provocative discussion concerns targeted temperature management in nursing care. Collaborative efforts for the use of therapeutic hypothermia on injured patients are summarized in a hospital setting. Steps in the implementation of therapeutic hypothermia, as well as strategies for changing clinical behavior, are emphasized. These talks highlight the importance of various caregivers and the recruitment of critical members to work together to make successful programs. A Letter to the Editor by Aibiki et al. is timely in that it responds to the recent findings of an important article on targeted temperature management after cardiac arrest recently published by Nielsen et al. (2013). This particular publication has generated a lot of discussion within the field, and this Letter emphasizes the importance of precise temperature control between the various experimental groups. Several original articles provide new information regarding a variety of timely areas of interest. The study by Bazley et al. emphasizes the benefits of local hypothermia in the treatment of spinal cord injury. Kander et al. provide new information regarding hypothermia and a hypocoagulative response in cardiac arrest patients. In another study, Iannacon
et al. explore the feasibility of utilizing a laptop-based neurocognitive battery to identify subtle cognitive deficits in cardiac arrest survivors undergoing targeted temperature management. Finally, Johnson et al. evaluate the safety and feasibility of moderate hypothermia as an intraoperative neuroprotective strategy for the removal of intradural spinal tumors. Together, these original articles emphasize the breadth of publications currently being presented in our journal. Finally, the latest edition of the ARCTIC Challenge summarizes an impressive list of questions and answers regarding the use of therapeutic hypothermia in several patient populations. Concerns regarding the effects of temperature modification on encephalogram (EEG) monitoring are highlighted. The rationale for listing recent hemorrhage as a contraindication for the use of hypothermia after cardiac arrest is also raised. Evidence for the use of hypothermia in spinal cord injury is reviewed as this experimental treatment is translated to the clinic. Together, this question and answer section provides the reader with a rich source of new information that can help guide therapeutic treatments. We thank our authors for their submissions of high-quality manuscripts and for contributing significantly to the journal. We greatly appreciate our international editorial board and reviewers for ensuring timely critiques that enhance the quality of our publication. We look forward to your continued participation as we strive to improve the the journal and expand our readership. —W. Dalton Dietrich, PhD Editor-in-Chief Reference
Nielsen N, Wetterslev J, Friberg H, TTM Trial Steering Group. Targeted temperature management after cardiac arrest. N Engl J Med 2014;370:1360.
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Editorial
Editorial Comment W. Dalton Dietrich, PhD
I
n this issue of Therapeutic Hypothermia and Temperature Management, we provide a number of informative articles that summarize progress in the area of temperature management strategies targeting different types of human disorders. Two expert panel discussions/roundtables held at the 4th Annual Therapeutic Hypothermia and Temperature Management Conference in Miami in 2014 are highlighted. The first discussion summarizes recent work in the area of targeted temperature management after a variety of injuries, including novel temperature management strategies in patients with large burns. The consequences of early cooling to reduce the frequency of post-traumatic epilepsy, as well as the beneficial effects of hypothermia in patients after neonatal encephalopathy, are also discussed. A second provocative discussion concerns targeted temperature management in nursing care. Collaborative efforts for the use of therapeutic hypothermia on injured patients are summarized in a hospital setting. Steps in the implementation of therapeutic hypothermia, as well as strategies for changing clinical behavior, are emphasized. These talks highlight the importance of various caregivers and the recruitment of critical members to work together to make successful programs. A Letter to the Editor by Aibiki et al. is timely in that it responds to the recent findings of an important article on targeted temperature management after cardiac arrest recently published by Nielsen et al. (2013). This particular publication has generated a lot of discussion within the field, and this Letter emphasizes the importance of precise temperature control between the various experimental groups. Several original articles provide new information regarding a variety of timely areas of interest. The study by Bazley et al. emphasizes the benefits of local hypothermia in the treatment of spinal cord injury. Kander et al. provide new information regarding hypothermia and a hypocoagulative response in cardiac arrest patients. In another study, Iannacon
et al. explore the feasibility of utilizing a laptop-based neurocognitive battery to identify subtle cognitive deficits in cardiac arrest survivors undergoing targeted temperature management. Finally, Johnson et al. evaluate the safety and feasibility of moderate hypothermia as an intraoperative neuroprotective strategy for the removal of intradural spinal tumors. Together, these original articles emphasize the breadth of publications currently being presented in our journal. Finally, the latest edition of the ARCTIC Challenge summarizes an impressive list of questions and answers regarding the use of therapeutic hypothermia in several patient populations. Concerns regarding the effects of temperature modification on encephalogram (EEG) monitoring are highlighted. The rationale for listing recent hemorrhage as a contraindication for the use of hypothermia after cardiac arrest is also raised. Evidence for the use of hypothermia in spinal cord injury is reviewed as this experimental treatment is translated to the clinic. Together, this question and answer section provides the reader with a rich source of new information that can help guide therapeutic treatments. We thank our authors for their submissions of high-quality manuscripts and for contributing significantly to the journal. We greatly appreciate our international editorial board and reviewers for ensuring timely critiques that enhance the quality of our publication. We look forward to your continued participation as we strive to improve the the journal and expand our readership. —W. Dalton Dietrich, PhD Editor-in-Chief Reference
Nielsen N, Wetterslev J, Friberg H, TTM Trial Steering Group. Targeted temperature management after cardiac arrest. N Engl J Med 2014;370:1360.
103
