Mild hypothermia in the prevention of brain edema in acute liver failure: mechanisms and clinical prospects.

Abstract:

:Mild hypothermia (32 degrees C-35 degrees C) reduces intracranial pressure in patients with acute liver failure and may offer an effective adjunct therapy in the management of these patients. Studies in experimental animals suggest that this beneficial effect of hypothermia is the result of a decrease in blood-brain ammonia transfer resulting in improvement in brain energy metabolism and normalization of glutamatergic synaptic regulation. Improvement in brain energy metabolism by hypothermia may result from a reduction in ammonia-induced decrease of brain glucose (pyruvate) oxidation. Restoration of normal glutamatergic synaptic regulation by hypothermia may be the consequence of the removal of ammonia-induced decreases in expression of astrocytic glutamate transporters resulting in normal glutamate neurotransmitter inactivation in brain. Randomized controlled clinical trials of hypothermia are required to further evaluate its clinical impact.

journal_name

Metab Brain Dis

journal_title

Metabolic brain disease

authors

Chatauret N,Rose C,Butterworth RF

doi

10.1023/a:1021982523691

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

445-51

issue

4

eissn

0885-7490

issn

1573-7365

journal_volume

17

pub_type

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