Hypothermia brain injury

M.Y. Globus, O. Alonso, W.A. Dietrich, R. Busto, and M.D. Ginsberg, Glutamate release and free radical production following brain injury effects of posttraumatic hypothermia. J. Neurochem. 65, 1704-1711 (1995). 

Hypothermia improves imbalances of TXA2 and PGI2 after traumatic brain injury in humans (Aibiki et al., 2000). 

Several trials have confirmed the benefit of hypothermia following perinatal hypoxic-ischemic injury (76,77). It has been noted, however, that brain or body cooling has not produced improved outcomes that are as dramatic as those seen in animal studies, when the brain injury can be precisely timed. It is evident then that the most significant variable over which little control... 

Discrepancies between results from the preliminary studies and the larger, multicenter trials remain to be elucidated. Significant intercenter variance in patient management (fluids, mean arterial blood pressure, ICP, and CPP) and treatment may have adversely affected the results of one of these trials (The National Acute Brain Injury Study Hypothermia) (61). Despite the overall negative findings, however, it is quite possible that certain subgroups of patients may benefit from treatment with mild hypothermia. 

Gunn A. J. (2000) Cerebral hypothermia for prevention of brain injury following perinatal asphyxia. Curr. Opin. Pediatr. 12,111-115. 

Clifton G. L., Allen S., Barrodale P., et al. (1993) A phase II study of moderate hypothermia in severe brain injury. J. Neurotrauma 10, 263-271 discussion 273. 

Clifton G. L., Choi S. C., Miller E. R., et al. (2001) Intercenter variance in clinical trials of head trauma—experience of the National Acute Brain Injury Study Hypothermia. J. Neurosurg. 95,751-755. 

Rosomoff H. L. (1959) Experimental brain injury during hypothermia. J. Neuro-surg. 16, 177-187. 

Quantitative strategies to evaluate the effects of posttraumatic temperature patterns of neuronal vulnerability in models of TBI have been conducted in several laboratories. The effect of posttraumatic hypothermia on histopathological outcome was first evaluated in a model of moderate parasagittal fluid percussion (F-P) brain injury (3). In that... 

Based on experimental and clinical data, cerebral hypothermia appears to be a potent therapeutic approach to treating brain trauma. However, recent results from the Multicenter National Brain Injury Study Hypothermia (NABIS H) clinical trial appear to be disappointing, and more refinement of the clinical application of hypothermia is required (73). Additional clinical trials are now required to evaluate systematically the beneficial effects of clinical hypothermia in different populations of brain-injured patients. In addition, experimental data regarding the beneficial effects of combination therapy are required to evaluate whether hypothermia plus pharmacotherapy may provide a better outcome. Forexample, mildpostischemichypothermia(33-39°C) combined with the antiinflammatory cytokine IL-10 has recently been reported to produce long-term protection of the C Al hippocampus after transient global ischemia (74). Hypothermia or IL-10 treatment alone did not protect chronically. In contrast, Kline etal. (75) showed that acute systemic administration of IL-10 suppressed the beneficial effects of... 

Dietrich W.D., Alonso O., BustoR., Globus M. Y., and Ginsberg M. D. (1994) Post-traumatic brain hypothermia reduces histopathological damage following concus-sive brain injury in the rat. Acta Neuropathol. 87, 250-258. 

Marion D. W. and White M. J. (1996) Treatment of experimental brain injury with moderate hypothermia and 21-aminosteroids. J. Neurotrauma 13, 139-147. 

Clifton G. L. (1995) Systemic hypothermia in treatment of severe brain injury a review and update. J. Neurotrauma 12, 923-927. 

Palmer A. M., Marion D. W., BotschellerM. L., and Redd E. E. (1993) Therapeutic hypothermia is cytoprotective without attenuating the traumatic brain injury-induced elevations in interstitial concentrations of aspartate and glutamate. J. Neurotrauma 10, 363-372. 

Bramlett H. M., Dietrich W. D., Green E. J., and Busto R. (1997) Chronic histopathological consequences of fluid-percussion brain injury in rats effects of post-traumatic hypothermia. Acta Neuropathol. (Berl.) 93,190-199. 

Matsushita Y., BramlettH. M., Alonso O., and Dietrich W. D. (2001) Posttraumatic hypothermia is neuroprotective in amodel of traumatic brain injury complicated by a secondary hypoxic insult. Crit. Care Med. 29, 2060-2066. 

Brodhun M., Fritz H., Walter B., et al. (2001) Immunomorphological sequelae of severe brain injury induced by fluid-percussion in juvenile pigs—effects of mild hypothermia. Ada NeuropathoL (Berl.) 101,424-434. 

Clifton G. L., Jiang J. Y., Lyeth B. G., Jenkins L. W., Hamm R. J., and Hayes R. L. (1991) Marked protection by moderate hypothermia after experimental traumatic brain injury../. Cereb. Blood Flow Metab. 11, 114—121. 

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