Skip to main content
SpringerLink
Log in

Therapeutic Hypothermia for Traumatic Brain Injury and Spinal Cord Injury

  • Chapter
  • First Online:
Neurotrauma Management for the Severely Injured Polytrauma Patient

Abstract

Induced hypothermia or targeted temperature management has been studied as a potential therapy for improving outcome following traumatic brain injury (TBI) and to a lesser extent, spinal cord injury (SCI). Hypothermia has been clearly demonstrated to improve clinical outcome following cardiac arrest. Preclinical TBI models have shown efficacy. Unfortunately, to date, this is not true for clinical moderate to severe TBI in humans. The same is true for spinal cord injury (SCI). As a result, there is insufficient evidence to support the routine use of induced hypothermia for improving outcome following TBI or SCI. The one clinical condition for which induced hypothermia may be useful is reducing elevated intracranial pressure (ICP) that is recalcitrant to standard medical therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Belanger M, Allaman I, Magistretti PJ. Brain energy metabolism: focus on astrocyte-neuron metabolic cooperation. Cell Metab. 2011;14(6):724–38.

    Article  CAS  PubMed  Google Scholar 

  2. Jain V, Langham MC, Wehrli FW. MRI estimation of global brain oxygen consumption rate. J Cereb Blood Flow Metab. 2010;30(9):1598–607.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Clinic C. Human Nerophysiology 2007. Available from: http://www.humanneurophysiology.com/cbfo2consumption.htm.

  4. Ling G. Traumatic brain injury and spinal cord injury. In: Goldman L, Schafer A, editors. Cecil’s Textbook of Medicine, 25th Edition: Elsevier; 2015.

    Google Scholar 

  5. Broessner G, Fischer M, Shubert G, Metzler B, Schumtzhard E. Therapeutic hypothermia in traumatic brain injury. Crit Care. 2012;16(Suppl 2):A1–42.

    PubMed Central  Google Scholar 

  6. Dietrich WD, Alonso O, Busto R, Globus MY, Ginsberg MD. Post-traumatic brain hypothermia reduces histopathological damage following concussive brain injury in the rat. Acta Neuropathol. 1994;87(3):250–8.

    Article  CAS  PubMed  Google Scholar 

  7. 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 Engl J Med. 2002;346(8):557–63.

    Article  PubMed  Google Scholar 

  8. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–56.

    Google Scholar 

  9. Arrich J, Holzer M, Havel C, Mullner M, Herkner H. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane Database Syst Rev. 2012;9:CD004128.

    Google Scholar 

  10. Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WG, Billi J, et al. Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation. 2003;108(1):118–21.

    Article  CAS  PubMed  Google Scholar 

  11. Moler FW, Holubkov R, Dean JM. Therapeutic Hypothermia in Children. N Engl J Med. 2015;373(10):980.

    Article  CAS  PubMed  Google Scholar 

  12. Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, et al. Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med. 1997;336(8):540–6.

    Article  CAS  PubMed  Google Scholar 

  13. Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med. 2001;344(8):556–63.

    Article  CAS  PubMed  Google Scholar 

  14. Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, et al. Hypothermia on admission in patients with severe brain injury. J Neurotrauma. 2002;19(3):293–301.

    Article  PubMed  Google Scholar 

  15. 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 randomised trial. Lancet Neurol. 2011;10(2):131–9.

    Article  PubMed  Google Scholar 

  16. Andrews PJ, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JK, et al. Hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med. 2015;373(25):2403–12.

    Article  CAS  PubMed  Google Scholar 

  17. Hutchison JS, Ward RE, Lacroix J, Hebert PC, Barnes MA, Bohn DJ, et al. Hypothermia therapy after traumatic brain injury in children. N Engl J Med. 2008;358(23):2447–56.

    Article  CAS  PubMed  Google Scholar 

  18. Adelson PD, Wisniewski SR, Beca J, Brown SD, Bell M, Muizelaar JP, et al. Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial. Lancet Neurol. 2013;12(6):546–53.

    Article  PubMed  Google Scholar 

  19. Sydenham E, Roberts I, Alderson P. Hypothermia for traumatic head injury. Cochrane Database Syst Rev. 2009(2):CD001048.

    Google Scholar 

  20. Fox JL, Vu EN, Doyle-Waters M, Brubacher JR, Abu-Laban R, Hu Z. Prophylactic hypothermia for traumatic brain injury: a quantitative systematic review. Cjem. 2010;12(4):355–64.

    Article  PubMed  Google Scholar 

  21. Crossley S, Reid J, McLatchie R, Hayton J, Clark C, MacDougall M, et al. A systematic review of therapeutic hypothermia for adult patients following traumatic brain injury. Crit Care. 2014;18(2):R75.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kwon BK, Mann C, Sohn HM, Hilibrand AS, Phillips FM, Wang JC, et al. Hypothermia for spinal cord injury. Spine J. 2008;8(6):859–74.

    Article  PubMed  Google Scholar 

  23. Dididze M, Green BA, Dietrich WD, Vanni S, Wang MY, Levi AD. Systemic hypothermia in acute cervical spinal cord injury: a case-controlled study. Spinal Cord. 2013;51(5):395–400.

    Article  CAS  PubMed  Google Scholar 

  24. Hansebout RR, Hansebout CR. Local cooling for traumatic spinal cord injury: outcomes in 20 patients and review of the literature. J Neurosurg Spine. 2014;20(5):550–61.

    Article  PubMed  Google Scholar 

  25. Sadaka F, Veremakis C, Lakshmanan R, Palagiri A. Therapeutic hypothermia in traumatic brain injury. Therapeutic Hypothermia in Brain Injury: InTech, Chapters; 2013.

    Google Scholar 

  26. Andrews RJ, Bringas JR, Alonzo G. Cerebrospinal fluid pH and PCO2 rapidly follow arterial blood pH and PCO2 with changes in ventilation. Neurosurgery. 1994;34(3):466–70; discussion 70.

    Google Scholar 

  27. Tokutomi T, Miyagi T, Takeuchi Y, Karukaya T, Katsuki H, Shigemori M. Effect of 35 degrees C hypothermia on intracranial pressure and clinical outcome in patients with severe traumatic brain injury. J Trauma. 2009;66(1):166–73.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurocritical Care, Depts of Neurology and Anesthesiology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Phipps 455, Baltimore, MD, 21287, USA

    Shamir Haji & Geoffrey S. F. Ling

  2. Dept of Neurology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA

    Geoffrey S. F. Ling

Authors
  1. Shamir Haji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Geoffrey S. F. Ling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Geoffrey S. F. Ling .

Editor information

Editors and Affiliations

  1. Neuroscience Department, Inova Neuroscience Institute Inova Fairfax Medical Campus, Falls Church, Virginia, USA

    James M. Ecklund

  2. Pediatric Neurosciences, Inova Neuroscience Institute, Falls Church, Virginia, USA

    Leon E. Moores

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Haji, S., Ling, G.S.F. (2017). Therapeutic Hypothermia for Traumatic Brain Injury and Spinal Cord Injury. In: Ecklund, J., Moores, L. (eds) Neurotrauma Management for the Severely Injured Polytrauma Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-40208-6_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40208-6_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40206-2

  • Online ISBN: 978-3-319-40208-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation