TY - JOUR
T1 - Therapeutic Hypothermia for Neuroprotection
T2 - History, Mechanisms, Risks, and Clinical Applications
AU - Karnatovskaia, Lioudmila V.
AU - Wartenberg, Katja E.
AU - Freeman, William D.
PY - 2014/7
Y1 - 2014/7
N2 - 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°C-35°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.
AB - 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°C-35°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.
KW - clinical
KW - clinical specialty
KW - nervous system
KW - neurocritical care
KW - neurophysiology
KW - techniques
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=84992847197&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992847197&partnerID=8YFLogxK
U2 - 10.1177/1941874413519802
DO - 10.1177/1941874413519802
M3 - Article
AN - SCOPUS:84992847197
SN - 1941-8744
VL - 4
SP - 153
EP - 163
JO - The Neurohospitalist
JF - The Neurohospitalist
IS - 3
ER -