Therapeutic hypothermia translates from ancient history in to practice.

Abstract:

:Acute postasphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a "dream revisited". In this review, a historical perspective is provided from the first reported use of therapeutic hypothermia for brain injuries in antiquity, to the present day. The first uncontrolled trials of cooling for resuscitation were reported more than 50 y ago. The seminal insight that led to the modern revival of studies of neuroprotection was that after profound asphyxia, many brain cells show initial recovery from the insult during a short "latent" phase, typically lasting ~6 h, only to die hours to days later during a "secondary" deterioration phase characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Studies designed around this conceptual framework showed that mild hypothermia initiated as early as possible before the onset of secondary deterioration, and continued for a sufficient duration to allow the secondary deterioration to resolve, is associated with potent, long-lasting neuroprotection. There is now compelling evidence from randomized controlled trials that mild induced hypothermia significantly improves intact survival and neurodevelopmental outcomes to midchildhood.

journal_name

Pediatr Res

journal_title

Pediatric research

authors

Gunn AJ,Laptook AR,Robertson NJ,Barks JD,Thoresen M,Wassink G,Bennet L

doi

10.1038/pr.2016.198

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

202-209

issue

1-2

eissn

0031-3998

issn

1530-0447

pii

pr2016198

journal_volume

81

pub_type

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