
Sakamoto and Noritoshi Ito (Japan) presented the findings of the
SAVE-J study, a prospective registry of patients who underwent
extracorporeal E-CPR vs standard care. Marc Conterato (Minneapolis)
presented the case for induced hypothermia/ECMO in pre-hospital
care for patients with refractory cardiac arrest with the experience of
the Minnesota Resuscitation Consortium initiative.
Raimund Helbok (Innsbruck, Austria), who leads research in a
major tertiary university hospital where multimodality monitoring
is a standard of care, demonstrated the clinical utility of online
monitoring of brain metabolism using microdialysis during TTM.
The session received further contributions by Tobias Cronberg
(Sweden) on the Lund experience of using continuous EEG for
monitoring after cardiac arrest, Jonathan Rhodes (Edinburgh,
Scotland) on the findings of brain tissue oxygen monitoring
in TBI from the Eurotherm study, Anders Aneman (Sydney,
Australia) on cerebrovascular autoregulation studies in postcardiac
arrest patients who received TTM, Kei Nishiyama (Japan)
on TTM stratified by regional SO2 as measured by near infrared
spectroscopy (NIRS), in addition to discussions on postresuscitation
brain monitoring by Markus Skrifvars (Helsinki,
Finland) and Xiaofeng Jia (Baltimore).
Thematic sessions on the practical implementation of TTM was
opened by a lecture entitled “Pharmacology and Induced Cooling:
a Two-Way Street” by NCS immediate past president Gretchen
Brophy (Virginia). Novel modalities of cooling featured in a
session presented by Jon Rittenberger (Pittsburgh), Fred Rincon
(Philadelphia), Kelly Harbour (Sydney) and Takahiro Miki (Japan).
Chair Manoj Saxena discussed fever prevention or induced
normothermia for TBI as a concept for future study while
some key current studies were then presented. Hans Friberg
(Lund, Sweden) presented the international multicentre TTM-2
study after cardiac arrest, David Greer (Boston) presented the
INTREPID study of fever prevention for acute vascular brain
injury while Hitoshi Kobata (Osaka, Japan) discussed how
hypothermia induced prior to emergent evacuation of acute
subdural haemorrhage might influence outcome, as studied
in the HOPES trial. This was followed by presentations of
recent published clinical trials, including the HEAT study
of permissive hyperthermia in severe sepsis by Paul Young
(Wellington, New Zealand), the paediatric cardiac arrest
trials by John Beca (Auckland, New Zealand), the J-Pulse
HYPO registry by Hiroshi Nonogi (Shizuoka, Japan),
the Hypothermia for Septic Shock study by Morten
Bestle (Copenhagen), TTM studies for septic shock and
meningitis by Frederique Schortgen (Paris) and the Timedifferentiated
Therapeutic Hypothermia (TTH48) trial by Hans
Kirkegaard (Aarhus, Denmark).
One of the highlights of the symposium was a session devoted
to improving how we assess long-term outcomes after brain
injury. Following plenaries by Gisela Lilja (Lund, Sweden)
and Carol Hodgson (Melbourne, Australia) on measuring
outcomes in terms of neurocognitive and physical function,
respectively, an interactive discussion followed in which a panel of
multidisciplinary experts engaged with patients who had suffered
traumatic brain injury and stroke. This well-received and widely
acclaimed session offered the opportunity for both faculty and
delegates to interact and learn about what really matters to our
patients as an outcome after a life-changing brain injury.
Finally, one of the features of the IHTMS is the award of
the Hayashi prize for the best oral abstract presentation of
experimental or clinical research. This year, it was awarded to
Akihiko Inoue (Japan) for his presentation, “Increased heart rate
response during the rewarming phase of therapeutic hypothermia
is associated with favorable neurological outcomes in out-ofhospital
cardiac arrest patients.” Ome deto, mata au ma de
(congratulations, and ’til we meet again)!
Andrew Cheng, MD, is senior staff intensivist at St. George Hospital,
a major teaching hospital in Sydney for the University of New South
Wales, with clinical focus in neurocritical care. His research interests
include targeted temperature management in acute brain injury.
Cheng was convener for the seventh International Hypothermia and
Temperature Management Symposium.
Gretchen Brophy delivering her lecture
on “The Pharmacology of Induced
Hypothermia: a Two-Way Street.”
The Australian Zoo, located in Darling Harbour, was the setting of
the welcome ceremony that greeted delegates to the Symposium.
Dining with faculty
and friends on Sydney
Harbour at the IHTMS.
Award of the Hayashi Prize to Akihito
Inoue of Japan by Symposium Chair,
Manoj Saxena. 17