Head and Neck Cooling Decreases Tympanic and Skin Temperature, But Significantly Increases Blood Pressure
- 1 August 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 43 (8), 2142-2148
- https://doi.org/10.1161/strokeaha.112.652248
Abstract
Background and Purpose—: Localized head and neck cooling might be suited to induce therapeutic hypothermia in acute brain injury such as stroke. Safety issues of head and neck cooling are undetermined and may include cardiovascular autonomic side effects that were identified in this study. Methods—: Ten healthy men (age 35±13 years) underwent 120 minutes of combined head and neck cooling (Sovika, HVM Medical). Before and after onset of cooling, after 60 and 120 minutes, we determined rectal, tympanic, and forehead skin temperatures, RR intervals, systolic and diastolic blood pressures (BP), laser-Doppler skin blood flow at the index finger and cheek, and spectral powers of mainly sympathetic low-frequency (0.04–0.15 Hz) and parasympathetic high-frequency (0.15–0.5 Hz) RR interval oscillations and sympathetic low-frequency oscillations of BP. We compared values before and during cooling using analysis of variance with post hoc analysis; (significance, P P =0.004) after 120 minutes, whereas skin blood flow fell significantly during cooling. RR intervals and parasympathetic RR interval high-frequency powers increased with cooling onset and were significantly higher after 60 and 120 minutes than they were before cooling. Conclusions—: Head and neck cooling prominently reduced tympanic temperature and thus might also induce intracerebral hypothermia; however, it did not significantly lower body core temperature. Profound skin temperature decrease induced sympathetically mediated peripheral vasoconstriction and prominent BP increases that are not offset by simultaneous parasympathetic heart rate slowing. Prominent peripheral vasoconstriction and BP increase must be considered as possibly harmful during head and neck cooling.This publication has 29 references indexed in Scilit:
- High NIHSS Values Predict Impairment of Cardiovascular Autonomic ControlStroke, 2011
- The Significance of Blood Pressure Variability for the Development of Hemorrhagic Transformation in Acute Ischemic StrokeStroke, 2010
- Therapeutic Hypothermia for Acute Ischemic Stroke: Ready to Start Large Randomized Trials?Journal of Cerebral Blood Flow & Metabolism, 2010
- Bench-to-bedside review: Hypothermia in traumatic brain injuryCritical Care, 2010
- Baroreflex: A New Therapeutic Target in Human Stroke?Stroke, 2009
- Association of Characteristics of Blood Pressure Profiles and Stroke Outcomes in the ECASS-II TrialStroke, 2008
- Cardiovascular autonomic function in poststroke patientsNeurology, 2007
- Terminal vessel hyperperfusion despite organ hypoperfusion in familial dysautonomiaClinical Science, 2003
- Acute Hypertension Promotes Hemorrhagic Transformation in a Rabbit Embolic Stroke Model: Effect of LabetalolExperimental Neurology, 1998
- Thermoregulatory Vasoconstriction Impairs Active Core CoolingAnesthesiology, 1995