Hypothermia for Neuroprotection

  • C. K. Spiss
  • U. M. Illievich
Conference paper


Specific effects of hypothermia on the various organ systems of the adult have led to the use of clinical temperature ranges, where hypothermia is defined as mild (36.5–34°C), moderate (33.5–28°C), deep (27.5–17°C), or profound (16.5–4°C) [1].


Core Temperature Severe Head Injury Brain Temperature Mild Hypothermia Cereb Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hitchcock CR, Strobel CJA, Haglin JJ et al (1962) Use of prolonged moderate hypothermia in postoperative care. Arch Surg 85: 549–556PubMedCrossRefGoogle Scholar
  2. 2.
    Michenfelder JD, Milde JH (1992) The effect of profound levels of hypothermia (below 14°C) on canine cerebral metabolism. J Cereb Blood Flow Metab 12(5): 877–880PubMedCrossRefGoogle Scholar
  3. 3.
    Michenfelder JD, Milde JH (1991) The relationship among canine brain temperature, metabolism and function during hypothermia. Anesthesiology 75: 130–136PubMedCrossRefGoogle Scholar
  4. 4.
    Hayward JN, Baker MA (1968) Role of cerebral arterial blood in the regulation of brain temperature in the monkey. Am J Physiol 215: 389–403PubMedGoogle Scholar
  5. 5.
    Mellergård P (1994) Monitoring of rectal, epidural, and intraventricular temperature in neurosurgical patients. Acta Neurochir Suppl Wien 60: 485–487PubMedGoogle Scholar
  6. 6.
    Hossmann KA, Kleihues P (1973) Reversibility of ischemic brain damage. Arch Neurol 29(6): 375–384PubMedCrossRefGoogle Scholar
  7. 7.
    Busto R, Dietrich WD, Globus MY et al (1987) Small differences in intraischemic brain temperature critically determine the extent of ischemic neuronal injury. J Cereb Blood Flow Metab 7: 729–738PubMedCrossRefGoogle Scholar
  8. 8.
    Mariak Z, Lewko J, Luczaj J et al (1994) The relationship between directly measured human cerebral and tympanic temperatures during changes in brain temperatures. Eur J Appl Physiol 69: 545–549CrossRefGoogle Scholar
  9. 9.
    Whitby JD, Dunkin LJ (1971) Cerebral, oesophageal and nasopharyngeal temperatures. British Journal of Anaesthesia 43: 673–676PubMedCrossRefGoogle Scholar
  10. 10.
    Serota HM, Gerard RW (1938) Localized temperature changes in the cat brain. J Neurophysiol 1: 115–124Google Scholar
  11. 11.
    Mellergård P, Nordstrom CH (1990) Epidural temperature and possible intracerebral temperature gradients in man. Br J Neurosurg 4(1): 31–38PubMedCrossRefGoogle Scholar
  12. 12.
    Mellergård P, Nordstrom CH (1991) Intracerebral temperature in neurosurgical patients. Neurosurgery 28(5): 709–713PubMedCrossRefGoogle Scholar
  13. 13.
    Sessler DI, McGuire J, Moayeri A et al (1991) Isoflurane-induced vasodilation minimally increases cutaneous heat loss. Anesthesiology 74(2): 226–232PubMedCrossRefGoogle Scholar
  14. 14.
    Kurz A, Kurz M, Poeschl G et al (1993) Forced-air warming maintains intraoperative normothermia better than circulating-water mattresses. Anesth Analg 77(1): 89–95PubMedCrossRefGoogle Scholar
  15. 15.
    Bacher A, Illievich UM, Fitzgerald R et al (1997) Changes in oxygenation variables during progressive hypothermia in anesthetized patients. J Neurosurg Anesth 9 (in press)Google Scholar
  16. 16.
    Hynson JM, Sessler DI, Moayeri A et al (1993) Absence of nonshivering thermogenesis in anesthetized adult humans. Anesthesiology 79(4): 695–703PubMedCrossRefGoogle Scholar
  17. 17.
    Erdewyk JMV (1994) Blood gas temperature correction. In: Faust RJ (ed) Anesthesiology review, 2nd edn, Churchill Livingstone, pp 25-26Google Scholar
  18. 18.
    Verhaegen MJ, Todd MM, Hindman BJ et al (1993) Cerebral autoregulation during moderate hypothermia in rats. Stroke 24(3): 407–414PubMedCrossRefGoogle Scholar
  19. 19.
    Michenfelder JD, Theye RA (1970) The effects of anesthesia and hypothermia on canine cerebral ATP and lactate during anoxia produced by decapitation. Anesthesiology 33: 430–439PubMedCrossRefGoogle Scholar
  20. 20.
    Minamisawa H, Nordstrom CH, Smith ML et al (1990) The influence of mild body and brain hypothermia on ischemic brain damage. J Cereb Blood Flow Metab 10(3): 365–374PubMedCrossRefGoogle Scholar
  21. 21.
    Welsh FA, Sims RE, Harris VA (1990) Mild hypothermia prevents ischemic injury in gerbil hippocampus. J Cereb Blood Flow Metab 10(4): 557–563PubMedCrossRefGoogle Scholar
  22. 22.
    Shiozaki T, Sugimoto H, Taneda M et al (1993) Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury. J Neurosurg 79(3): 363–368PubMedCrossRefGoogle Scholar
  23. 23.
    Marion DW, Obrist WD, Carlier PM et al (1993) The use of moderate therapeutic hypothermia for patients with severe head injuries: a preliminary report. J Neurosurg 79(3): 354–362PubMedCrossRefGoogle Scholar
  24. 24.
    Clifton GL, Allen S, Barrodale P et al (1993) A phase II study of moderate hypothermia in severe brain injury. J Neurotrauma 10(3): 263–271PubMedCrossRefGoogle Scholar
  25. 25.
    Busto R, Globus MY, Dietrich WD et al (1989) Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain. Stroke 20(7): 904–910PubMedCrossRefGoogle Scholar
  26. 26.
    Illievich UM, Zornow MH, Choi KT et al (1994) Effects of hypothermie metabolic suppression on hippocampal glutamate concentrations after transient global cerebral ischemia. Anesthesia & Analgesia 78: 905–911CrossRefGoogle Scholar
  27. 27.
    Katsura K, Minamisawa H, Ekholm A et al (1992) Changes of labile metabolites during anoxia in moderately hypo-and hyperthermic rats: correlation to membrane fluxes of K+. Brain Res 590(1-2): 6–12PubMedCrossRefGoogle Scholar
  28. 28.
    Widmann R, Miyazawa T, Hossmann KA (1993) Protective effect of hypothermia on hippocampal injury after 30 minutes of forebrain ischemia in rats is mediated by postischemic recovery of protein synthesis. J Neurochem 61(1): 200–209PubMedCrossRefGoogle Scholar
  29. 29.
    Cardell M, Boris MF, Wieloch T (1991) Hypothermia prevents the ischemia-induced translocation and inhibition of protein kinase C in the rat striatum. J Neurochem 57(5): 1814–1817PubMedCrossRefGoogle Scholar
  30. 30.
    Lei B, Tan X, Cai H et al (1994) Effect of moderate hypothermia on lipid peroxidation in canine brain tissue after cardiac arrest and resuscitation. Stroke 25(1): 147–152PubMedCrossRefGoogle Scholar
  31. 31.
    Edwards AD, Yue X, Squier MV et al (1995) Specific inhibition of apoptosis after cerebral hypoxia-ischaemia by moderate post-insult hypothermia. Biochem Biophys Res Commun 217(3): 1193–1199PubMedCrossRefGoogle Scholar
  32. 32.
    Jiang JY, Lyeth BG, Kapasi MZ et al (1992) Moderate hypothermia reduces blood-brain barrier disruption following traumatic brain injury in the rat. Acta Neuropathol Berl 84(5): 495–500PubMedCrossRefGoogle Scholar
  33. 33.
    Marion DW, Penrod LE, Kelsey SF et al (1997) Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 336(8): 540–546PubMedCrossRefGoogle Scholar
  34. 34.
    Harari A, Regnier B, Rapin M et al (1975) Haemodynamic study of prolonged deep accidental hypothermia. Eur J Intensive Care Med 1(2): 65–70PubMedCrossRefGoogle Scholar
  35. 35.
    Gould L, Gopalaswamy C, Kim BS et al (1985) The Osborn wave in hypothermia. Angiology 36(2): 125–129PubMedCrossRefGoogle Scholar
  36. 36.
    Okada M (1984) The cardiac rhythm in accidental hypothermia. J Electrocardiol 17(2): 123–128PubMedCrossRefGoogle Scholar
  37. 37.
    Chen RY, Chien S (1978) Hemodynamic functions and blood viscosity in surface hypothermia. Am J Physiol 235(2): H136–H143PubMedGoogle Scholar
  38. 38.
    Morray JP, Pavlin EG (1990) Oxygen delivery and consumption during hypothermia and rewarming in the dog. Anesthesiology 72(3): 510–516PubMedCrossRefGoogle Scholar
  39. 39.
    Wilson JT, Miller WR (1958) Blood studies in the hypothermic dog. Surgery 43: 979–989Google Scholar
  40. 40.
    Resnick DK, Marion DW, Darby JM (1994) The effect of hypothermia on the incidence of delayed traumatic intracerebral hemorrhage. Neurosurgery 34(2): 252–255PubMedCrossRefGoogle Scholar
  41. 41.
    Oss Cv, Absolom D, Moore L et al (1980) Effect of temperature on chemotaxis, phagocytic engulfment, digestion, and O2 consumption of human polymorphonuclear leucocytes. J Reticuloendothelial Soc 27: 561–565Google Scholar
  42. 42.
    Kurz A, Sessler DI, Lenhardt R (1996) Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. N Engl J Med 334: 1209–1215PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • C. K. Spiss
  • U. M. Illievich

There are no affiliations available

Personalised recommendations