{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:34:13Z","timestamp":1777916053952,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Open pulmonary endarterectomy (PEA) carries a high risk of neurological complications due to cerebral hypoperfusion and ischemia\u2013reperfusion injury. Systemic cooling during extracorporeal circulation may not sufficiently reduce brain temperature. Combining systemic and targeted head\u2013neck cooling may enhance neuroprotection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective study, 22 PEA patients were analyzed. All underwent deep systemic hypothermia (22\u201324\u00b0C). Eleven received adjunctive external head cooling using the Aurora head\u2013neck device, and eleven used ice packs (Control). Cerebral oxygenation was monitored with near-infrared spectroscopy (NIRS), and neuron-specific enolase (NSE) levels were measured preoperatively and postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cerebral desaturation events (rSO\n                      <jats:sub>2<\/jats:sub>\n                      &lt; 40%) occurred in 22.2% of Aurora patients versus 77.8% of Controls (p = 0.030). Postoperative NSE levels were lower in the Aurora group; however, the difference did not reach statistical significance (p = 0.087).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dual-modality cooling combining extracorporeal hypothermia and targeted head\u2013neck cooling improved intraoperative cerebral oxygenation and were associated with lower postoperative NSE levels; however, due to the limited sample size, no definitive conclusions regarding neuronal injury can be drawn.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261429813","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:47:10Z","timestamp":1776340030000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Brain tissue perfusion during pulmonary endarterectomy - The impact of controlled regional cooling"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7182-9700","authenticated-orcid":false,"given":"Roberto","family":"Veronesi","sequence":"first","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Bozzini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Dezza","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Rossini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Milanesi","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Toscani","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Maria","family":"D\u2019Armini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Belliato","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01294-2024"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.06.052"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resplu.2023.100360"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.09.042"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-023-01800-7"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2022.07.007"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.538"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-76979-6"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-016-0257-7"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/neurolint16030050"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.10.008"},{"issue":"2","key":"e_1_3_6_13_2","first-page":"43","article-title":"Effectiveness of mild to moderate hypothermic cardiopulmonary bypass in improving clinical outcomes","volume":"9","author":"Song Y","year":"2022","unstructured":"Song Y, Li C, Yu J, et al. Effectiveness of mild to moderate hypothermic cardiopulmonary bypass in improving clinical outcomes. J Cardiovasc Dev Dis 2022; 9(2): 43.","journal-title":"J Cardiovasc Dev Dis"},{"issue":"2","key":"e_1_3_6_14_2","first-page":"609","article-title":"Hypothermia in cardiac surgery in the modern era","volume":"101","author":"Seco M","year":"2016","unstructured":"Seco M, Edelman JJ, Suen JY, et al. Hypothermia in cardiac surgery in the modern era. Ann Thorac Surg 2016; 101(2): 609\u2013610.","journal-title":"Ann Thorac Surg"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2020.11.035"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261429813","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261429813","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261429813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:36:59Z","timestamp":1777657019000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261429813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":14,"alternative-id":["10.1177\/02676591261429813"],"URL":"https:\/\/doi.org\/10.1177\/02676591261429813","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"article-number":"02676591261429813"}}