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Current Treatment Options in Neurology

Erschienen in:

01.12.2012 | CEREBROVASCULAR DISORDERS (HP ADAMS JR, SECTION EDITOR)

Overview of Therapeutic Hypothermia

verfasst von: Shlee S. Song, MD, Patrick D. Lyden, MD, FAAN, FAHA

Erschienen in: Current Treatment Options in Neurology | Ausgabe 6/2012

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Opinion statement

Therapeutic hypothermia has proven neuroprotective effects in global cerebral ischemia. Indications for hypothermia induction include cardiac arrest and neonatal asphyxia. The two general methods of induced hypothermia are either surface cooling or endovascular cooling. Hypothermia should be induced as early as possible to achieve maximum neuroprotection and edema blocking effect. Endovascular cooling has the benefit of shorter time to reach target temperature but catheter insertion requires expertise and training, which may be a barrier to widespread availability. The optimum method of cooling is yet to be determined but a multimodal approach is necessary to address three phases of cooling: induction, maintentance, and rewarm. Specifying core practitioners who are well-versed in established guidelines can help integrate the multidisciplinary team that is needed to successfully implement cooling protocols. Reducing shivering to make heat exchange more efficient with tighter temperature control enables quicker time to target temperature and avoids rewarming which can lead to inadvertent increase in intracranial pressure and cerebral edema. Promising applications but yet to be determined is whether hypothermia treatment can improve outcomes in acute ischemic stroke or traumatic brain injury.

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Eng J Med. 2002;346:549–56.

Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Eng J Med. 2002;346:557–63.CrossRef

Seupaul RA, Wilbur LG. Evidence-based emergency medicine. Does therapeutic hypothermia benefit survivors of cardiac arrest? Ann Emerg Med. 2011;58:282–3.PubMedCrossRef

Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Eng J Med. 2005;353:1574–84.CrossRef

Hippocrates. De vetere medicina. 460–375 BC.

Benson DW, Williams Jr GR, Spencer FC, Yates AJ. The use of hypothermia after cardiac arrest. Anesth Analg. 1959;38:423–8.PubMedCrossRef

Sterz F, Safar P, Tisherman S, Radovsky A, Kuboyama K, Oku K. Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med. 1991;19:379–89.PubMedCrossRef

Hicks SD, DeFranco DB, Callaway CW. Hypothermia during reperfusion after asphyxial cardiac arrest improves functional recovery and selectively alters stress-induced protein expression. Journal of Cerebral Blood Flow and Metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. 2000;20:520–30.

D'Cruz BJ, Fertig KC, Filiano AJ, Hicks SD, DeFranco DB, Callaway CW. Hypothermic reperfusion after cardiac arrest augments brain-derived neurotrophic factor activation. Journal of Cerebral Blood Flow and Metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism. 2002;22:843–51.

10.

2005 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005;112:IV1–203.

11.

Brooks SC, Morrison LJ. Implementation of therapeutic hypothermia guidelines for post-cardiac arrest syndrome at a glacial pace: seeking guidance from the knowledge translation literature. Resuscitation. 2008;77:286–92.PubMedCrossRef

12.

Metz C, Holzschuh M, Bein T, Woertgen C, Frey A, Frey I, et al. Moderate hypothermia in patients with severe head injury: cerebral and extracerebral effects. J Neurosurg. 1996;85:533–41.PubMedCrossRef

13.

Karibe H, Zarow GJ, Graham SH, Weinstein PR. Mild intraischemic hypothermia reduces postischemic hyperperfusion, delayed postischemic hypoperfusion, blood-brain barrier disruption, brain edema, and neuronal damage volume after temporary focal cerebral ischemia in rats. Journal of Cerebral Blood Flow and Metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism. 1994;14:620–7.

14.

Maier CM, Sun GH, Cheng D, Yenari MA, Chan PH, Steinberg GK. Effects of mild hypothermia on superoxide anion production, superoxide dismutase expression, and activity following transient focal cerebral ischemia. Neurobiol Dis. 2002;11:28–42.PubMedCrossRef

15.

Kawai N, Kawanishi M, Okauchi M, Nagao S. Effects of hypothermia on thrombin-induced brain edema formation. Brain Res. 2001;895:50–8.PubMedCrossRef

16.

Guluma KZ, Oh H, Yu SW, Meyer BC, Rapp K, Lyden PD. Effect of endovascular hypothermia on acute ischemic edema: morphometric analysis of the ictus trial. Neurocrit Care. 2008;8:42–7.PubMedCrossRef

17.

Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke; J Cereb Circ. 2001;32:2033–5.CrossRef

18.

Krieger DW, De Georgia MA, Abou-Chebl A, Andrefsky JC, Sila CA, Katzan IL, et al. Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke. Stroke; J Cereb Circ. 2001;32:1847–54.CrossRef

19.

Lazzaro MA, Prabhakaran S. Induced hypothermia in acute ischemic stroke. Expt Opin Investig Drugs. 2008;17:1161–74.CrossRef

20.

Gillies MA, Pratt R, Whiteley C, Borg J, Beale RJ, Tibby SM. Therapeutic hypothermia after cardiac arrest: a retrospective comparison of surface and endovascular cooling techniques. Resuscitation. 2010;81:1117–22.PubMedCrossRef

21.

Qiu W, Shen H, Zhang Y, Wang W, Liu W, Jiang Q, et al. Noninvasive selective brain cooling by head and neck cooling is protective in severe traumatic brain injury. J Clin Neurosci. 2006;13:995–1000.PubMedCrossRef

22.

Wang H, Olivero W, Lanzino G, Elkins W, Rose J, Honings D, et al. Rapid and selective cerebral hypothermia achieved using a cooling helmet. J Neurosurg. 2004;100:272–7.PubMedCrossRef

23.

Keller E, Mudra R, Gugl C, Seule M, Mink S, Frohlich J. Theoretical evaluations of therapeutic systemic and local cerebral hypothermia. J Neurosci Methods. 2009;178:345–9.PubMedCrossRef

24.

Zweifler RM, Voorhees ME, Mahmood MA, Alday DD. Induction and maintenance of mild hypothermia by surface cooling in nonintubated subjects. J Stroke Cerebrovasc Dis. 2003;12:237–43.PubMedCrossRef

25.

Castren M, Nordberg P, Svensson L, Taccone F, Vincent JL, Desruelles D, et al. Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (prince: Pre-rosc intranasal cooling effectiveness). Circulation. 2010;122:729–36.PubMedCrossRef

26.•

Hemmen TM, Raman R, Guluma KZ, Meyer BC, Gomes JA, Cruz-Flores S, et al. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ictus-l). Final results. Stroke. 2010;41:2265–70.PubMedCrossRef

27.

De Georgia MA, Krieger DW, Abou-Chebl A, Devlin TG, Jauss M, Davis SM, et al. Cooling for acute ischemic brain damage (cool aid): a feasibility trial of endovascular cooling. Neurology. 2004;63:312–7.PubMedCrossRef

28.•

Lyden P, Ernstrom K, Cruz-Flores S, Gomes J, Grotta J, Mullin A, et al. Determinants of effective cooling during endovascular hypothermia. Neurocrit Care. 2012;16:413–20.PubMedCrossRef

29.

van der Worp HB, Macleod MR, Kollmar R. Therapeutic hypothermia for acute ischemic stroke: ready to start large randomized trials? J Cereb Blood Flow Metab. 2010;30:1079–93.PubMedCrossRef

30.

Mack WJ, Huang J, Winfree C, Kim G, Oppermann M, Dobak J, et al. Ultrarapid, convection-enhanced intravascular hypothermia: a feasibility study in nonhuman primate stroke. Stroke. 2003;34:1994–9.PubMedCrossRef

31.

Flint AC, Hemphill JC, Bonovich DC. Therapeutic hypothermia after cardiac arrest: performance characteristics and safety of surface cooling with or without endovascular cooling. Neurocrit Care. 2007;7:109–18.PubMedCrossRef

32.

Georgiadis D, Schwarz S, Kollmar R, Schwab S. Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach. Stroke. 2001;32:2550–3.PubMedCrossRef

33.

Jessen K. An assessment of human regulatory nonshivering thermogenesis. Acta Anaesthesiol Scand. 1980;24:138–43.PubMedCrossRef

34.

Kranke P, Eberhart LH, Roewer N, Tramer MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg. 2002;94:453–60. table of contents.PubMed

35.

Weant KA, Martin JE, Humphries RL, Cook AM. Pharmacologic options for reducing the shivering response to therapeutic hypothermia. Pharmacotherapy 30:830–41.

36.

Miyazawa T, Tamura A, Fukui S, Hossmann KA. Effect of mild hypothermia on focal cerebral ischemia. Review of experimental studies. Neurol Res. 2003;25:457–64.PubMedCrossRef

37.

Adelson PD, Ragheb J, Kanev P, Brockmeyer D, Beers SR, Brown SD, et al. Phase II clinical trial of moderate hypothermia after severe traumatic brain injury in children. Neurosurgery. 2005;56:740–54; discussion 740–5.PubMedCrossRef

38.

Jaramillo A, Gongora-Rivera F, Labreuche J, Hauw JJ, Amarenco P. Predictors for malignant middle cerebral artery infarctions: a postmortem analysis. Neurology. 2006;66:815–20.PubMedCrossRef

39.

Krieger DW, Demchuk AM, Kasner SE, Jauss M, Hantson L. Early clinical and radiological predictors of fatal brain swelling in ischemic stroke. Stroke. 1999;30:287–92.PubMedCrossRef

40.

Barber PA, Demchuk AM, Zhang J, Kasner SE, Hill MD, Berrouschot J, et al. Computed tomographic parameters predicting fatal outcome in large middle cerebral artery infarction. Cerebrovasc Dis. 2003;16:230–5.PubMedCrossRef

41.

Delgado P, Sahuquillo J, Poca MA, Alvarez-Sabin J. Neuroprotection in malignant mca infarction. Cerebrovasc Dis. 2006;21 Suppl 2:99–105.PubMedCrossRef

42.

Chen H, Chopp M, Welch KM. Effect of mild hyperthermia on the ischemic infarct volume after middle cerebral artery occlusion in the rat. Neurology. 1991;41:1133–5.PubMedCrossRef

43.

Zhang RL, Chopp M, Chen H, Garcia JH, Zhang ZG. Postischemic (1 hour) hypothermia significantly reduces ischemic cell damage in rats subjected to 2 hours of middle cerebral artery occlusion. Stroke. 1993;24:1235–40.PubMedCrossRef

44.

Dietrich WD, Busto R, Alonso O, Globus MY, Ginsberg MD. Intraischemic but not postischemic brain hypothermia protects chronically following global forebrain ischemia in rats. J Cereb Blood Flow Metab. 1993;13:541–9.PubMedCrossRef

45.

Colbourne F, Corbett D. Delayed postischemic hypothermia: a 6 month survival study using behavioral and histological assessments of neuroprotection. J Neurosci. 1995;15:7250–60.PubMed

46.

Yanamoto H, Nagata I, Nakahara I, Tohnai N, Zhang Z, Kikuchi H. Combination of intraischemic and postischemic hypothermia provides potent and persistent neuroprotection against temporary focal ischemia in rats. Stroke. 1999;30:2720–6; discussion 2726.PubMedCrossRef

47.

Colbourne F, Li H, Buchan AM. Indefatigable ca1 sector neuroprotection with mild hypothermia induced 6 hours after severe forebrain ischemia in rats. J Cereb Blood Flow Metab. 1999;19:742–9.PubMedCrossRef

48.

Polderman KH. Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet. 2008;371:1955–69.PubMedCrossRef

49.

Kammersgaard LP, Rasmussen BH, Jorgensen HS, Reith J, Weber U, Olsen TS. Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: a case-control study: the copenhagen stroke study. Stroke; J Cereb Circ. 2000;31:2251–6.CrossRef

50.

Sydenham E, Roberts I, Alderson P. Hypothermia for traumatic head injury. Cochrane Database Syst Rev. 2009:CD001048.

51.

Clifton GL, Valadka A, Zygun D, Coffey CS, Drever P, Fourwinds S, et al. Very early hypothermia induction in patients with severe brain injury (the national acute brain injury study: Hypothermia II): a randomized trial. Lancet Neurol. 2011;10:131–9.PubMedCrossRef

Titel: Overview of Therapeutic Hypothermia
verfasst von: Shlee S. Song, MD
Patrick D. Lyden, MD, FAAN, FAHA
Publikationsdatum: 01.12.2012
Verlag: Current Science Inc.
Erschienen in: Current Treatment Options in Neurology / Ausgabe 6/2012
Print ISSN: 1092-8480
Elektronische ISSN: 1534-3138
DOI: https://doi.org/10.1007/s11940-012-0201-x

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Overview of Therapeutic Hypothermia

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