New Concept of Brain Hypothermia Treatment
The basic concept of brain hypothermia treatment is the control of brain tissue temperature to between 32° and 34°C, maintenance of systemic circulation- metabolism, neurohormonal control, and stabilization of the immune function, for the restoration of injured neurons . Reduced brain metabolism for neuroprotection from brain ischemia and the prevention of intracranial pressure (ICP) elevation are not initial goals. To restore dying neurons in injured brain tissue, hypothermia itself is not sufficient. Administration of oxygen, stabilization of brain metabolism with adequate metabolic substrates, and prevention of excess neurohormonal reactions of the hypothalamus-pituitaryadrenal (HPA) axis are the initial goals of brain hypothermia [13, 14, 15]. The early induction of mild to moderate brain hypothermia (32–34°C) is very successful in the prevention of hazardous excess neurohormonal reactions of HPA axis. Early anesthesia is also helpful in preventing excess stimulation of the HPA axis [9,10, 14, 15, 16].
KeywordsBrain Edema Brain Damage Severe Brain Injury Excess Release Hypothermia Treatment
Unable to display preview. Download preview PDF.
- 2.Baker AJ, Zornow MH, Scheller MS, Yaksh TL, Skilling SR, Smullin DH, Larson AA, Kuczenski R (1991) Changes in extracellular concentrations of glutamate, aspartate, glycine, dopamine, serotonin, and dopamine metabolites after transient global ischemia in the rat. J Neurochem 57:1370–1379PubMedCrossRefGoogle Scholar
- 10.Hayashi N (1997) Prevention of vegetation after severe head trauma and stroke by combination therapy of cerebral hypothermia and activation of immunedopaminergic nervous system. Proceedings of the 6th annual meeting of Society for Treatment of Coma 6:133–145Google Scholar
- 16.Hayashi N, Hirayama T, Utagawa A (1994) The cerebral thermo-pooling and hypothermia treatment of critical head injury patients. In: Nagai H (ed) Intracranial pressure IX. Springer, Berlin Heidelberg New York Tokyo, pp 589–599Google Scholar
- 19.Macintosh TK (1994) Neurological sequele of traumatic brain injury: therapeutic implications. Cerebrovasc Brain Metab Rev 6:109–162Google Scholar
- 20.Macintosh TK, Hayes R, DeWitt D, Agura V, Faden AI (1987) Endogenous opioids may mediate secondary damage after experimental brain injury. Am J Physiol 258:E565–E574Google Scholar
- 23.Nagao K, Hayashi N, Kanmatsuse K, Arima K, Ohtsuki J, Kikushima K, Watanabe I (2000) Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital. J Am Coll Cardiol 36:776–783PubMedCrossRefGoogle Scholar
- 26.Silvka A, Coben G (1985) Hydroxyl radical attack on dopamine. J Biol Chem 260:15466–15472Google Scholar