Mistakes and Pitfalls of Brain Hypothermia Treatment

  • Nariyuki Hayashi
  • Dalton W. Dietrich


To prevent brain edema, early administration of manitol and glycerol were recommended previously [21]. However, brain edema progresses not only as a secondary pathophysiological change [23] of directly injured brain tissue, but also by hypothalamus-pituitary-adrenal (HPA) axis neurohoromonal dysfunction [4,9] such as cardiopulmonary dysfunction caused by catecholamine surge [9], masking brain hypoxia [9], brain thermo-pooling [7,8,12], insulin-resistant hyperglycemia [7,9,12], and vasopressin-related blood-brain barrier (BBB) dysfunction [8,14]. Therefore, prevention of secondary brain damage caused by HPA axis neurohoromonal dysfunction should precede management of brain edema by administration of manitol and glycerol [9].


Brain Edema Severe Brain Injury Vasopressin Release Hypothermia Treatment Albumin Ratio 


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Copyright information

© Springer Japan 2004

Authors and Affiliations

  • Nariyuki Hayashi
    • 1
    • 2
  • Dalton W. Dietrich
    • 3
    • 4
  1. 1.Nihon University Emergency Medical CenterTokyoJapan
  2. 2.Department of Emergency and Critical Care MedicineNihon University School of MedicineTokyoJapan
  3. 3.Department of Neurological Surgery, Neurology and Cell Biology and AnatomyUniversity of Miami School of MedicineMiamiUSA
  4. 4.The Miami Project to Cure ParalysisMiamiUSA

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