TTM Connection
   

 

 


TTM CONNECTION—Where Science Meets Education

Therapeutic Hypothermia and Temperature Management

We welcome you to the Targeted Temperature Management quarterly newsletter sponsored by the Global Science Center for TTM

The Journal Therapeutic Hypothermia and Temperature Management is happy to offer to its readers the TTM Connection. This quarterly newsletter seeks to highlight news from around the world in TTM as well as provide links to multimedia information such as videos, podcasts, and webinars. Additionally, upcoming events are listed at the bottom. We hope our readers enjoy this content and take advantage of the resources, lectures, and other educational events.

 

 
 
 

Global Science Center


Jennifer Williams

Phil Abenojar

Health Professionals
The Science Center is focused on Targeted Temperature Management (TTM) by Advancing the delivery of health care education.  This scientific platform will cover all aspects of therapeutic hypothermia and controlled normothermia specifically in disease states such as cardiac arrest, spinal cord injury, traumatic brain injury, stroke, intracerebral hemorrhage, SAH, and burns.  

Scientific Advancements and Research
Discover and learn about Targeted Temperature Management. We will provide resources and documented findings as well as clinical studies, review articles, biological discoveries and contributions from scientists throughout the globe.    

Targeted Temperature Events
Upcoming dates for scholarly lectures, webinars, seminars and educational events throughout the globe will be published in the newsletter. Please review the event calendar of all upcoming TTM Events below. 

The Audio and Video Library
The Center better seeks to understand and disseminate the protective mechanism of TTM, both therapeutic  hypothermia and controlled normothermia, and to improve awareness by providing a unified collection of simple and easily accessible audio and video library of academic information.  The TTM Connection contains links to some of these videos below.

Highest Regards,
Dr. Jennifer Williams and Phil Abenojar RN, BSN
(Medical Science Liaisons)

 



Updates from the Field

Cognitive impairment less likely with therapeutic hypothermia
Most cardiac arrest patients who receive therapeutic hypothermia maintained their cognitive function and returned to work and daily activities, according to a study presented by researchers from the Rochester, Minn., Mayo Clinic at the American Academy of Neurology annual meeting. The study, conducted with Vanderbilt University in Nashville, Tenn., evaluated long-term cognitive abilities of patients who had survived an out-of-hospital cardiac arrest and then received therapeutic hypothermia. The investigators reviewed 133 patients' medical records from June 2006 to May 2011 and interviewed 56 patients by telephone to assess cognitive status. All of the cardiac arrest patients were treated with therapeutic hypothermia. More than half of the patients, 58%, were alive at 21 months, the mean follow up, and 91% were living independently. The researchers considered 60% of the patients cognitively normal and 40% cognitively impaired. Seventy-nine percent of the patients who were working when the cardiac arrest occurred were back at work. More>>

Study looks at using therapeutic hypothermia for severe acute pancreatitis
New York University School of Medicine has begun a Phase IIa pilot clinical trial to determine the effectiveness of therapeutic hypothermia in the treatment of acute pancreatitis. They will examine the effects of therapeutic hypothermia on organ-specific outcomes during the early stage of acute pancreatitis on five patients, aged 18 to 80, receiving medically necessary ventilator support under ICU monitoring with core temperatures ≥ 36°C and severe acute pancreatitis. All patients will receive current standard management for severe acute pancreatitis and a standardized protocol for application of therapeutic hypothermia and rewarming, then they will evaluate organ-specific cardiovascular, respiratory, hematological, renal, and metabolic dysfunction at 28 days. More>>

Vanderbilt studying cooling STEMI patients
Researchers at the Vanderbilt Heart and Vascular Institute in Nashville, Tenn., are participating in the VELOCITY randomized, controlled trial to assess the safety and feasibility of quickly cooling ST-elevation myocardial infarction patients to reduce the amount of damage caused by the event. Vanderbilt has enrolled its first two patients and is one of several U.S. and Canadian hospitals that will together enroll 60 participants. Patients in the intervention group will be cooled to 35°C within 15 minutes just prior to receiving a percutaneous coronary intervention, and the controls will receive the cardiovascular intervention without therapeutic hypothermia, the current standard of care. They will assess whether the cooling prevents reperfusion injury. The first patient randomized to hypothermia at Vanderbilt did well, said Pete Fong, MD, assistant professor of Medicine, who cared for the second patient enrolled in the study. More>>

Scots investigate brain cooling
Healthy volunteers in Scotland are participating in research at the University of Edinburgh's Centre for Clinical Brain Sciences to determine whether cooling the brain could improve outcomes for patients with stroke. Patients undergoing chemotherapy already use therapeutic hypothermia to help prevent hair loss. Researchers do not know at this point, if the cooling penetrates the scalp and reaches the brain. This £9.5 million ($14.5 million USD), four-year study aims to determine that. Researchers are cooling the brains of participants in the study and monitoring the response. Prior pilot studies indicate that cooling the brain could reduce mortality and improve patients' quality of life. The investigators said, if the technique proves beneficial, ambulance crews could begin the cooling process en route to the hospital. More>>

Hypothermia boot camp scheduled for October
The next two-day Hypothermia and Resuscitation Training Institute at Penn (HART) boot camp will be held October 10-11, 2013, at the Loews Philadelphia Hotel in Philadelphia. The course will educate providers, including physicians, nurses, physician extenders, and first responders, about in-hospital care of cardiac arrest patients. Presenters will review the history, evidence, and pathophysiology associated with the use of therapeutic hypothermia. After completing the class, participants should be able to create a protocol for their institution, with appropriate inclusion and exclusion criteria, and then implement therapeutic temperature management. They also will learn how to develop a post-cardiac arrest bundle. The boot camp includes simulations and a certification exam. More>>

Trial to investigate cooling for stroke patients
The University of Erlangen-Nürnberg Medical School in Germany is investigating whether therapeutic cooling improves outcomes for ischemic stroke patients. The study began in May. Study chair Stefan Schwab and colleagues plan to enroll 1500 people in the randomized, interventional study to determine if systemic cooling to a target temperature of 34°C to 35°C, started within six hours of symptom onset and maintained for 24 hours, improves functional outcome at three months in patients with acute ischemic stroke. All patients will receive best medical treatment. Patients in the intervention arm also will receive therapeutic hypothermia, via infusion of 4°C isotone saline or Ringer's lactate administered over a period of 30 to 60 minutes. After cooling for 24 hours, the team will rewarm the patient until 36°C has been reached. At three months, they will measure modified Rankin scale, mortality, neurological outcome, and quality of life. They will also monitor cerebral infarct size and the safety and tolerability of systemic cooling. More>>

DoD to study magnesium sulfate with hypothermia in TBI patients
The Department of Defense is sponsoring a randomized interventional trial to investigate whether hypothermia and additional magnesium sulfate will improve the outcome of severe traumatic brain injury (TBI) patients. The research team will compare the outcomes of patients with severe traumatic brain injury who have been allocated to one of the following three groups: conventional therapy following traumatic brain injury, subjects who will have their core body temperature lowered to 34°C or subjects who will have their core body temperature lowered to 34°C and will receive a supplemental intravenous infusion of magnesium sulfate. Investigators plan to enroll 105 patients, and at discharge from the hospital, within two months of injury, they will measure the participants' Glasgow Outcome Score. They will again measure that at three, six and 12 months post-injury and monitor for vasospasm on an ongoing basis, as measured by transcranial Doppler and transcranial arteriography. The research is taking place at Memorial Regional Medical Center in Hollywood, Fla., Greg Zorman, MD, is the principal investigator. More>>

Compilation of hospitals that offer therapeutic hypothermia
The Perelman School of Medicine at University of Pennsylvania has created a resource of all hospitals that offer therapeutic hypothermia for post cardiac-arrest patients. The resource features hospitals in the U.S. and worldwide and provides links to the hospital's website, where applicable. An interactive map of the hospitals that offer therapeutic hypothermia is also available. More>>

 


Expert Spotlight
 

Mary Kay Bader

Expert Spotlight:

Practicing in a variety of hospitals (teaching/community) across the country, Mary Kay Bader has functioned in roles such as ICU staff nurse, trauma nurse responder, clinical educator, clinical faculty, and clinical nurse specialist. She has held clinical and joint faculty positions at Georgetown University and Loyola University of Chicago. Currently, Ms. Bader is employed as a neuroscience/critical care clinical nurse specialist at Mission Hospital in Mission Viejo California working collaboratively with neurosurgeons, trauma surgeons, neurologists, intensivists, nurses, therapists, and pharmacists. Ms. Bader has lectured locally, regionally, nationally and internationally on subjects such as traumatic brain injury, spinal cord injury, increased intracranial pressure, stroke, neurointerventional therapy, hypothermia, and aneurysms.

Bio:
Mary Kay Bader has been a nurse for 35 years with an emphasis in neuroscience/critical care nurse for 31 years. She received her BSN from St. Mary's College Notre Dame Indiana and her MSN from Loyola University of Chicago. She has been CCRN certified since 1982 and CNRN since 1983 and received her CCNS in 2006. Ms. Bader received her SCRN (Stroke Certified Registered Nurse) certification in 2013. She has published in the following journals: Journal of Neuroscience Nursing, Critical Care Nursing Clinics of North America, AACN Clinical Issues, Journal of Cardiovascular Nursing, Heart and Lung, Critical Care Nurse, Dimensions in Critical care, Journal of Trauma, and Neurocritical Care. Ms. Bader is the co-editor for the 2010 and 2004 AANN Core Curriculum for Neuroscience Nursing. She is the only nursing member of the editorial board for the journal Therapeutic Hypothermia and Temperature Management. She has served on the editorial board of the American Journal of Critical Care and Critical Care Nurse. She is a reviewer for Critical Care Nurse and the American Heart Association. Ms. Bader served on the Neurocritical care Society Board of directors from 2008-2012 and serves as the President of AANN. She is co-editor of 2008 AACN AANN Protocols for Practice in Neuro Critical Care. Ms. Bader is on the Medical Advisory Board for the Brain Trauma Foundation and on Neuroptics.

She has received the following awards: 2009 AACN Flame of Excellence Award, 2008 AACN Circle of Excellence Award – CNS, 2005 AACN Circle of Excellence Award – Mentor, 2004 Bayada Technology in Nursing Award, 2001 AACN Outstanding Advanced Practice Nurse, 1999 Excellence Core Value Award at Mission Hospital, and 1996 Excellence in Interdisciplinary Collaboration from Georgetown University Hospital. She has been a member of the team receiving the following awards: 2001 AACN Innovision Award, 2000 AACN Multidisciplinary Team Award, and 2000 and 2008 Ernest Codman Award from the Joint Commission on Accreditation of Hospital/ Organizations. In 2008, she was appointed as a Fellow of the American Heart Association (FAHA).

 

 
Expert on the Move
Resources Events

Farid G. Sadaka, MD

WEBINAR: Normothermia in Brain Injury
Featured Speaker: Farid G. Sadaka, MD
Mercy Hospital St. Louis/ St. Louis University St. Louis, MO

Recorded Session, Duration: 1 Hour



PODCAST
SCCM Pod-212 CCM: Therapeutic Hypothermia Following Sudden Cardiac Arrest

Jeffrey Guy, MD, MSc, MMHC, speaks with David R. Janz, MD, lead author on an article published in the December issue of Critical Care Medicine, “Hyperoxia is Associated with Increased Mortality in Patients Treated with Mild Therapeutic Hypothermia after Sudden Cardiac Arrest.” Investigators found that sudden cardiac arrest is associated with high hospital mortality and poor neurologic outcomes. Janz is a clinical fellow at Vanderbilt University School of Medicine in Nashville, Tennessee.

EDUCATION & TRAINING
ENLS certificationNCS’ New ENLS Course Addresses the First Critical Hour of a Neurological Emergency
The Neurocritical Care Society (NCS) is a multidisciplinary, international organization whose mission is to improve outcomes for patients with life-threatening neurological illnesses.  Emergency Neurological Life Support (ENLS) has just been introduced and it is already drawing positive comments from career professionals. ENLS is designed to help standardize the approach to neurological emergencies during the first critical hour. Included in the 13 topic areas are Ischemic Stroke, Subarachnoid Hemorrhage and Traumatic Brain Injury – and others that are very relevant to improving outcomes. Besides physicians and nurses, ENLS is also recommended for physician assistants, pharmacists, residents and fellows – all members of the team confronted with a neurological emergency who want to enhance their knowledge and preparedness. The course provides 15 hours of Level 1 CME credit and two-year ENLS certification on completion.
More on ENLS     More on NCS

 

Upcoming in August:

Kees Polderman WFSICCM Congress

Talk: Therapeutic hypothermia and controlled normothermia: side effects, protocols and patient management.

Starting a temperature management protocol in your unit: implementation issues.

Speaker:
Kees Polderman, MD, PhD

Date/ Time: Aug 30th,  2:30 pm
Durban, South Africa

Place: WFSICCM Congress

 

 

The Global Science Center does not endorse or recommend any products, processes, or services. The views and opinions of authors expressed in the Global Science Center "TTM Connection" Newsletter do not necessarily state or reflect those opinions of the Global Science Center and or the MSL team. The provided links to other internet sites or content are only for the convenience of the recipients.  The Global Science Center and or the MSL team is not responsible for the content of these external sites. 

It is not the intention to provide specific medical advice, but rather to provide recipients with educational material to better understand the role of TTM. Specific medical advice will not be provided, and on the behalf of the MSL team and or the Global Science Center we urge you to consult with a qualified health care provider to discuss the benefits and risks of any presented therapies. The information provided is not to constitute an "authoritative statement".