Abstract
Recent investigations have emphasized the importance of the rewarming phase in determining whether brain cooling is protective. Slow but not rapid rewarming provides the benefit in terms of histopathological outcome. In clinical studies, slow rewarming after a period of induced hypothermia is used routinely because of the potential detrimental effects of rebound intracranial hypertension when temperature increases rapidly [1,2,4]. In experimental studies, several reports recently emphasized the importance of slow rewarming in injury models [5,7]. For example, in a transient forebrain ischemia study, rapid rewarming failed to provide the neuroprotective effect of hypothermia that was observed with slow rewarming [6]. In that study, rapid rewarming, after hypothermia resulted in poor recovery of mean arterial blood pressure and cortical blood flow. These investigators suggested that aggravated uncoupling between blood flow and metabolism with rapid rewarming might reduce its protection with hypothermia.
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References
Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, Muizelaar JP, Wagner FC, Marion OW, Luerssen TG, Chesnut RM, Schwartz M (2001) Lack of effect of induction of hypothermia after acute brain injury. N Eng J Med 344:556–563
Enomoto S, Hindman BJ, Dexter F, Smith T, Cutkomp J (1996) Rapid rewarming causes an increase in the cerebral metabolic rate for oxygen that is temporarily unmatched by cerebral blood flow. Anesthesia 84:1392–1400
Koizumi H, Povlishock JT (1998) Posttraumatic hypothermia in the treatment of axonal damage in an animal model of traumatic axonal injury. J Neurosurg 89:303–309
Marion OW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, Wisniewki SR, DeKosky ST (1997) Treatment of traumatic brain injury with moderate hypothermia. N Eng J Med 336:540–546
Matsushita Y, Bramlett HM, Alonso OF, Dietrich WD (2001) Posttraumatic hypothermia is neuroprotective in a model of traumatic brain injury complicated by a secondary hypoxic insult. Crit Care Med 29:2060–2066
Nakamura T, Miyamoto O, Yanagami S-I, Hayashida Y, Itano T, Nagao S (1999) Influence of rewarming conditions after hypothermia in gerbils with transient forebrain ischemia. J Neurosurg 91:114–120
Suehiro E, Povlishock JT (2001) Rapid post hypothermic rewarming exacerbates traumatically induced axonal injury which is attenuated by cyclosporin A. J Neurosurg 94:493–498
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© 2004 Springer Japan
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Hayashi, N., Dietrich, D.W. (2004). Rewarming Phase. In: Brain Hypothermia Treatment. Springer, Tokyo. https://doi.org/10.1007/978-4-431-53953-7_10
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DOI: https://doi.org/10.1007/978-4-431-53953-7_10
Publisher Name: Springer, Tokyo
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