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Hypothermie als Therapiekonzept

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NeuroIntensiv

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Zusammenfassung

Hypothermie scheint tierexperimentell eine sehr erfolgversprechende Methode zu sein, akut geschädigtes Hirngewebe vor weiteren schädliche Einfl üssen zu schützen [20], [43]. Als physikalische Maßnahme greift Hypothermie im Gegensatz zu pharmakologischen Substanzen mit einem spezifi schen Wirkmechanismus an nahezu allen Stellen der pathophysiologischen Kaskade nach akuter Hirnschädigung an. Trotz ermutigender tierexperimenteller Ergebnisse konnte der klinische Nutzen der Hypothermiebehandlung mit positiver Auswirkung auf den neurologischen Status bislang nur für eine Subgruppe von Patienten mit globaler zerebraler Ischämie nach Herz-Kreislauf-Stillstand und für Neugeborene mit hypoxisch-ischämischer Enzephalopathie belegt werden [1], [14]. Die zunehmende Erfahrung in der Hypothermiebehandlung, Ergebnisse klinischer Studien und neue Verfahren zur Induktion/Aufrechterhaltung von Hypothermie sowie die Therapie von Nebenwirkungen werden in Zukunft zu neuen klinischen Studien auf allen Gebieten der akuten Hirnschädigung führen.

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Literatur

  1. Arrich J, et al. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane database of systematic reviews (Online) 2009(4):CD004128

    Google Scholar 

  2. Bernard SA, et al. Treatment of comatose survivors of out-ofhospital cardiac arrest with induced hypothermia. N Engl J Med 2002; 346(8):557–563

    Article  PubMed  Google Scholar 

  3. Busch H-J, et al. Safety and feasibility of nasopharyngeal evaporative cooling in the emergency department setting in survivors of cardiac arrest. Resuscitation 2010

    Google Scholar 

  4. Clifton GL, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344(8):556–563

    Article  PubMed  CAS  Google Scholar 

  5. Clifton GL, et al. Very early hypothermia induction in patients with severe brain injury (the National Acute Brain Injury Study: Hypothermia II): a randomised trial. Lancet Neurol, 2011. 10(2):131–139

    Article  PubMed  Google Scholar 

  6. De Georgia MA, et al. Cooling for Acute Ischemic Brain Damage (COOL AID): a feasibility trial of endovascular cooling. Neurology 2004; 63(2):312–317

    PubMed  Google Scholar 

  7. Enerbäck S. Human brown adipose tissue. Cell Metab 2010; 11(4):248–252

    Article  PubMed  Google Scholar 

  8. Fingas M, Clark DL, Colbourne F. The effects of selective brain hypothermia on intracerebral hemorrhage in rats. Exp Neurol 2007; 208(2): 277–284

    Article  PubMed  Google Scholar 

  9. Georgiadis D, et al. Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach. Stroke 2001; 32(11):2550–2553

    Article  PubMed  CAS  Google Scholar 

  10. Gillies MA, et al. Therapeutic hypothermia after cardiac arrest: A retrospective comparison of surface and endovascular cooling techniques. Resuscitation 2010

    Google Scholar 

  11. HACA. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002; 346(8):549–556

    Article  Google Scholar 

  12. Hemmen TM, et al. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results. Stroke; a journal of cerebral circulation 2010; 41(10):2265–2270

    Article  PubMed  Google Scholar 

  13. ILCOR. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 4: Advanced life support. Resuscitation 2005; 67(2–3):213–247

    Google Scholar 

  14. Jacobs S, et al. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane database of systematic reviews (Online) 2007(4):CD003311

    Google Scholar 

  15. Jordan JD, Carhuapoma JR. Hypothermia: comparing technology. J Neurol Sci, 2007; 261(1–2):35–38

    Article  PubMed  Google Scholar 

  16. Kawai N, et al. Effects of hypothermia on thrombin-induced brain edema formation. Brain Res 2001; 895(1–2): 50–58

    Article  PubMed  CAS  Google Scholar 

  17. Kawai N, Nakamura T, Nagao S. Effects of brain hypothermia on brain edema formation after intracerebral hemorrhage in rats. Acta Neurochir (Suppl) 2002; 81:233–235

    CAS  Google Scholar 

  18. Kim F, et al. Pilot randomized clinical trial of prehospital induction of mild hypothermia in out-of-hospital cardiac arrest patients with a rapid infusion of 4 degrees C normal saline. Circulation, 2007; 115(24):3064–3070

    Article  PubMed  Google Scholar 

  19. Kollmar R, et al. Ice-cold saline for the induction of mild hypothermia in patients with acute ischemic stroke: a pilot study. Stroke; a journal of cerebral circulation 2009; 40(5):1907–1979

    Article  PubMed  CAS  Google Scholar 

  20. Kollmar R, Schwab S. Therapeutic hypothermia in neurological critical care. Dtsch Med Wochenschr. 2010;135:2361–2365

    Article  PubMed  CAS  Google Scholar 

  21. Kollmar R, et al. Hypothermia Reduces Perihemorrhagic Edema After Intracerebral Hemorrhage. Stroke 2010; 41:1684–1689

    Article  PubMed  Google Scholar 

  22. Kranke P, et al. Single-dose parenteral pharmacological interventions for the prevention of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg 2004; 99(3):718–727, table of contents

    Article  PubMed  CAS  Google Scholar 

  23. Liu L, Yenari, Therapeutic hypothermia: neuroprotective mechanisms. Front Biosci 2007; 12:816–825

    Article  PubMed  CAS  Google Scholar 

  24. MacLellan CL, et al. The influence of hypothermia on outcome after intracerebral hemorrhage in rats. Stroke 2006; 37(5):1266–1270

    Article  PubMed  Google Scholar 

  25. Mahmood MA, Zweifler RM. Progress in shivering control. J Neurol Sci 2007; 261(1–2):47–54

    Article  PubMed  Google Scholar 

  26. Marion DW, et al. Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 1997; 336(8):540–546

    Article  PubMed  CAS  Google Scholar 

  27. Morrison LJ, et al. Part 8: Advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122(16 Suppl 2):S345–421

    Article  PubMed  Google Scholar 

  28. O'Collins VE, et al. 1,026 experimental treatments in acute stroke. Annals of neurology 2006. 59(3):467–477

    Article  PubMed  Google Scholar 

  29. Peterson K, Carson S, Carney N. Hypothermia treatment for traumatic brain injury: a systematic review and meta-analysis. J Neurotrauma 2008; 25(1):62–71

    Article  PubMed  Google Scholar 

  30. Polderman KH. Application of therapeutic hypothermia in the ICU: opportunities and pitfalls of a promising treatment modality. Part 1: Indications and evidence. Intensive care medicine 2004; 30(4):556–575

    Article  PubMed  Google Scholar 

  31. Polderman KH. Application of therapeutic hypothermia in the intensive care unit. Opportunities and pitfalls of a promising treatment modality - Part 2: Practical aspects and side effects. Intensive Care Med 2004; 30(5):757–769

    Article  PubMed  Google Scholar 

  32. Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Critical Care Medicine 2009. 37(7 Suppl):S186–202

    Article  PubMed  Google Scholar 

  33. Rutherford MA, et al. Mild hypothermia and the distribution of cerebral lesions in neonates with hypoxic-ischemic encephalopathy. Pediatrics 2005; 116(4):1001–1006

    Article  PubMed  Google Scholar 

  34. Saini M, et al. Effect of hyperthermia on prognosis after acute ischemic stroke. Stroke; a journal of cerebral circulation 2009; 40(9):3051–3059

    Article  PubMed  Google Scholar 

  35. Schwab S, et al. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke 2001; 32(9):2033–2035

    Article  PubMed  CAS  Google Scholar 

  36. Schwab S, et al. Moderate hypothermia in the treatment of patients with severe middle cerebral artery infarction. Stroke 1998; 29(12):2461–2466

    Article  PubMed  CAS  Google Scholar 

  37. Sena ES, et al. The impact of pethidine on the neuroprotective effects of hypothermia, in European Stroke Conference 2009; Stockholm, Sweden

    Google Scholar 

  38. Sessler DI. Defeating normal thermoregulatory defenses: induction of therapeutic hypothermia. Stroke; a journal of cerebral circulation 2009; 40(11): e614–621

    Article  PubMed  CAS  Google Scholar 

  39. Sessler DI. Thermoregulatory defense mechanisms. Crit Care Med 2009; 37(7 Suppl):S203–210

    Article  PubMed  CAS  Google Scholar 

  40. Thoresen M, et al. Twenty-four hours of mild hypothermia in unsedated newborn pigs starting after a severe global hypoxicischemic insult is not neuroprotective. Pediatr Res 2001; 50(3):405–411

    Article  PubMed  CAS  Google Scholar 

  41. Todd MM, et al. Mild intraoperative hypothermia during surgery for intracranial aneurysm. N Engl J Med 2005; 352(2):135–145

    Article  PubMed  CAS  Google Scholar 

  42. Tømte O, et al. A comparison of intravascular and surface cooling techniques in comatose cardiac arrest survivors. Crit Care Med 2011; 39(3):443–449

    Article  PubMed  Google Scholar 

  43. Van Der Worp HB, et al. Hypothermia in animal models of acute ischaemic stroke: a systematic review and meta-analysis. Brain 2007; 130(Pt 12):3063–3074

    Article  PubMed  Google Scholar 

  44. Wagner KR, et al. Delayed profound local brain hypothermia markedly reduces interleukin-1beta gene expression and vasogenic edema development in a porcine model of intracerebral hemorrhage. Acta Neurochir (Suppl) 2006; 96:177–182

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen

    Dr. R. Kollmar

  2. Neurologische Klinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg

    Dr. S. Poli

Authors
  1. Dr. R. Kollmar
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  2. Dr. S. Poli
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Editor information

Editors and Affiliations

  1. Neurologische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen

    Stefan Schwab

  2. Benediktuskrankenhaus, Neurologische Klinik und Geriatrie Johannes Wesling Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden

    Peter Schellinger

  3. Klinik für Anästhesiologie, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz

    Christian Werner

  4. Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg

    Andreas Unterberg  & Werner Hacke  & 

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Kollmar, R., Poli, S. (2012). Hypothermie als Therapiekonzept. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16911-3_15

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  • DOI: https://doi.org/10.1007/978-3-642-16911-3_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-16910-6

  • Online ISBN: 978-3-642-16911-3

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