Therapeutic Hypothermia for Neuroprotection: History, Mechanisms, Risks, and Clinical Applications

被引:92
作者
Karnatovskaia, Lioudmila V. [1 ,2 ]
Wartenberg, Katja E. [3 ]
Freeman, William D. [2 ,4 ,5 ]
机构
[1] Mayo Clin, Dept Pulm, Jacksonville, FL 32224 USA
[2] Mayo Clin, Dept Crit Care, Jacksonville, FL 32224 USA
[3] Martin Luther Univ Halle Wittenberg, Dept Neurol, Halle, Germany
[4] Mayo Clin, Dept Neurol, Jacksonville, FL 32224 USA
[5] Mayo Clin, Dept Neurosurg, Jacksonville, FL 32224 USA
关键词
neurocritical care; clinical specialty; trauma; nervous system; clinical; neurophysiology; techniques;
D O I
10.1177/1941874413519802
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The earliest recorded application of therapeutic hypothermia in medicine spans about 5000 years; however, its use has become widespread since 2002, following the demonstration of both safety and efficacy of regimens requiring only a mild (32 degrees C-35 degrees C) degree of cooling after cardiac arrest. We review the mechanisms by which hypothermia confers neuroprotection as well as its physiological effects by body system and its associated risks. With regard to clinical applications, we present evidence on the role of hypothermia in traumatic brain injury, intracranial pressure elevation, stroke, subarachnoid hemorrhage, spinal cord injury, hepatic encephalopathy, and neonatal peripartum encephalopathy. Based on the current knowledge and areas undergoing or in need of further exploration, we feel that therapeutic hypothermia holds promise in the treatment of patients with various forms of neurologic injury; however, additional quality studies are needed before its true role is fully known.
引用
收藏
页码:153 / 163
页数:11
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