Document Detail


Hypothermia for brain protection and resuscitation.
MedLine Citation:
PMID:  16960479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Clinicians are actively looking for an effective brain protection technique. With pharmacologic agents, several phase III trials in stroke, severe traumatic brain injury, and post-cardiac arrest survivors have failed. Hence there is renewed interest in mild to moderate hypothermia for brain protection. Phase III clinical trials with hypothermia have been successful only in post-cardiac arrest survivors and neonatal hypoxic encephalopathy. This review focuses on the possible reasons for our inability to translate into positive clinical trials what is observed consistently in laboratory models. RECENT FINDINGS: Several factors have been identified for the failure of successive hypothermia clinical trials. Patients with severe traumatic brain injury with Glasgow Coma Score of 4-7 on admission and those less than 45 years of age and neonates with hypoxic encephalopathy are more responsive to hypothermia. Similarly, early and effective cooling techniques and titration of hypothermia to a defined endpoint are likely to be more effective. New techniques such as local cooling of the brain and the combination of hypothermia with drugs are being evaluated. SUMMARY: Hypothermia can at present be recommended only for post-cardiac arrest survivors and in neonatal hypoxic encephalopathy.
Authors:
Ramachandran Ramani
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  19     ISSN:  0952-7907     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-08     Completed Date:  2007-01-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  487-91     Citation Subset:  IM    
Affiliation:
Yale University School of Medicine, New Haven, Connecticut 06520, USA. ramachandran.ramani@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Brain Damage, Chronic / etiology,  prevention & control*
Brain Injuries / complications,  mortality,  therapy*
Heart Arrest / complications,  mortality,  therapy*
Humans
Hypothermia, Induced* / methods,  trends
Hypoxia, Brain / complications,  mortality,  therapy*
Infant, Newborn
Infant, Newborn, Diseases / therapy
Middle Aged
Patient Selection
Randomized Controlled Trials as Topic
Resuscitation*
Severity of Illness Index
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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