Concepts in Brain Tissue Temperature Control
The basic concept of brain hypothermia treatment is the management of adequate cerebral oxygenation, administration of sufficient metabolic substrates for injured neurons, control of neurohormonal function, and stabilization of cardiopulmonary function [4,6]. The previous concept of neuroprotection to tolerate brain ischemia by reduced brain metabolism makes it difficult for dying neurons in injured brain tissue to make a recovery. Therefore, stable systemic circulation and metabolism are important initially. In severely brain-injured patients, cardiopulmonary dysfunction occurs because of stress associated with the excess release of catecholamines . This initial catecholamine surge [1,5] and neurohormonal response of the hypothalamuspituitary- adrenal (HPA) axis  produces cardiac dysfunction not only by cardiac ischemia with coronary spasm but also by cardio-myocytolysis with prolonged contraction of cardiac muscles. To prevent this cardiopulmonary dysfunction, control of catecholamine surge by early induction of brain hypothermia is very useful [4,6].
KeywordsBrain Edema Brain Damage Serum Glucose Level Metabolic Shift Intermittent Control
Unable to display preview. Download preview PDF.
- 4.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
- 7.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
- 9.Leibowitz SF (1999) Macronutrients and brain peptides: what they do and how they respond. In: Berthoud HR, Seeley RJ (eds) Neural and metabolic control of macronutrient intake. CRC, Boca Raton, pp 389–406Google Scholar
- 11.Macintosh TK (1994) Neurological sequele of traumatic brain injury: therapeutic implications. Cerebrovasc Brain Metab Rev 6:109–162Google Scholar
- 12.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