Zusammenfassung
Die Körper- und damit auch Gehirntemperatur beeinflusst tierexperimentell und klinisch das Ausmaß der zerebralen Schädigung sowie das funktionelle Outcome und die Mortalität nach akuter Hirnschädigung. Fieber verschlechtert experimentell und klinisch das Outcome. Bei therapeutischer Beeinflussung der Körper- oder Gehirntemperatur sind zu unterscheiden das sog. Targeted Temperature Management (TTM), bei dem eine bestimmte Temperatur Ziel der Interventionen ist – also auch Fiebertherapie –, von der sog. induzierten Hypothermie, bei der Körper- oder Gehirntemperatur unter den Normalwert gesenkt werden. Als physikalische Maßnahme greift induzierte Hypothermie im Gegensatz zu pharmakologischen Substanzen mit einem spezifischen Wirkmechanismus an nahezu allen Stellen der pathophysiologischen Kaskade nach akuter Hirnschädigung an. Die zunehmende Erfahrung in der Hypothermiebehandlung, Ergebnisse klinischer Studien und neue Verfahren zur Induktion/Aufrechterhaltung von Hypothermie sowie die Therapie von Nebenwirkungen führten zu neuen klinischen Studien auf nahezu allen Gebieten der akuten Hirnschädigung.
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Kollmar, R., Poli, S. (2015). Hypothermie und Targeted Temperature Management (TTM) als Therapiekonzept. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46500-4_15
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