Annals of Emergency Medicine
Volume 40, Issue 2 , Pages 220-230 , August 2002

Mild hypothermia in neurologic emergency: An update

Received 16 July 2001 ,Revised 14 December 2001 ,Accepted 16 January 2002.

References 

  1. Ginsberg MD, Sternau LL, Globus MY, et al.  Therapeutic modulation of brain temperature: relevance to ischemic brain injury. Cerebrovasc Brain Metab Rev. 1992;4:189–225
  2. Maher J, Hachinski V. Hypothermia as a potential treatment for cerebral ischemia. Cerebrovasc Brain Metab Rev. 1993;5:277–300
  3. Busto R, Dietrich WD, Globus MY-T, et al.  Small differences in intraischemic brain temperature critically determine the extent of ischemic neuronal injury. J Cereb Blood Flow Metab. 1987;7:729–738
  4. Sterz F, Zeiner A, Kurkciyan I, et al.  Mild resuscitative hypothermia and outcome after cardiopulmonary resuscitation. J Neurosurg Anesth. 1996;8:88–96
  5. Schwab S, Schwarz S, Spranger M, et al.  Moderate hypothermia in the treatment of patients with severe middle cerebral artery infarction. Stroke. 1998;29:2461–2466
  6. Bernard S. Induced hypothermia in intensive care medicine. Anaesth Intensive Care. 1996;24:382–388
  7. Shiozaki T, Sugimoto H, Taneda M, et al.  Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury. J Neurosurg. 1993;79:363–368
  8. Marion DW, Obrist WD, Carlier PM, et al.  The use of moderate therapeutic hypothermia for patients with severe head injuries: a preliminary report. J Neurosurg. 1993;79:354–362
  9. Clifton GL, Allen S, Barrodale P, et al.  A phase II study of moderate hypothermia in severe brain injury. J Neurotrauma. 1993;10:263–271
  10. Schwab S, Geordiadis D, Berrouschot J, et al.  Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke. 2001;32:2033–2035
  11. Mellergard P. Changes in human intracerebral temperature in response to different methods of brain cooling. Neurosurgery. 1992;31:671–677
  12. Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics. 1998;102:885–892
  13. Battin MR, Dezoete JA, Gunn TR, et al.  Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Pediatrics. 2001;107:480–484
  14. Rajek A, Greif R, Sessler DI, et al.  Core cooling by central venous infusion of ice-cold (4°C and 20°C) fluid: isolation of core and peripheral thermal compartments. Anesthesiology. 2000;93:629–637
  15. Georgiadis D, Schwarz S, Kollmar R, et al.  Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach. Stroke. 2001;32:2550–2553
  16. Schwartz AE, Stone JG, Pile-Spellman J, et al.  Selective cerebral hypothermia by means of transfemoral internal carotid artery catheterization. Radiology. 1996;201:571–572
  17. Ao H, Tanimoto H, Yoshitake A, et al.  Long-term mild hypothermia with extracorporeal lung and heart assist improves survival from prolonged cardiac arrest in dogs. Resuscitation. 2001;48:163–174
  18. Nagao K, Hayashi N, Kanmatsuse K, et al.  Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital. J Am Coll Cardiol. 2000;36:776–783
  19. Piepgras A, Roth H, Schurer L, et al.  Rapid active internal core cooling for induction of moderate hypothermia in head injury by use of an extracorporeal heat exchanger. Neurosurgery. 1998;42:311–318
  20. Henker RA, Brown SD, Marion DW. Comparison of brain temperature with bladder and rectal temperatures in adults with severe head injury. Neurosurgery. 1998;42:1071–1075
  21. Rossi S, Zanier ER, Mauri I, et al.  Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71:448–454
  22. Ao H, Moon JK, Tanimoto H, et al.  Jugular vein temperature reflects brain temperature during hypothermia. Resuscitation. 2000;45:111–118
  23. Mori K, Maeda M, Miyazaki M, et al.  Effects of mild (33) and moderate (29) hypothermia on cerebral blood flow and metabolism, lactate, and extracellular glutamate in experimental head injury. Neurol Res. 1998;20:719–726
  24. Maeda T, Katayama Y, Kawamata T, et al.  Mechanisms of excitatory amino acid release in contused bran tissue: effects of hypothermia and in situ administration of Co2+ on extracellular levels of glutamate. J Neurotrauma. 1998;15:655–664
  25. Kawai N, Nakamura T, Okauchi M, et al.  Effects of hypothermia on intracranial pressure and brain edema formation: studies in a rat acute subdural hematoma model. J Neurotrauma. 2000;17:193–202
  26. Xu RX, Nakamura T, Nagao S, et al.  Specific inhibition of apoptosis after cold-induced brain injury by moderate postinjury hypothermia. Neurosurgery. 1998;43:107–114
  27. Chatzipanteli K, Alonso OF, Kraydieh S, et al.  Importance of posttraumatic hypothermia and hyperthermia on the inflammatory response after fluid percussion brain injury: biochemical and immunocytochemical studies. J Cereb Blood Flow Metab. 2000;20:531–542
  28. Chatzipanteli k, Wada K, Busto R, et al.  Effects of moderate hypothermia on constitutive and inducible nitric oxide synthase activities after traumatic brain injury in the rat. J Neurochem. 1999;72:2047–2052
  29. Clark RS, Kochanek PM, Marion DW, et al.  Mild posttraumatic hypothermia reduces mortality after severe controlled cortical impact in rats. J Cereb Blood Flow Metab. 1996;16:253–261
  30. Clifton GL. Systemic hypothermia in treatment of severe brain injury: a review and update. J Neurotrauma. 1995;12:923–927
  31. Metz C, Holzschuh M, Bein T, et al.  Moderate hypothermia in patients with severe head injury: cerebral and extracerebral effects. J Neurosurg. 1996;85:533–541
  32. Jiang J, Yu M, Zhu C. Effect of long-term mild hypothermia therapy in patients with severe traumatic brain injury: 1-year follow-up review of 87 cases. J Neurosurg. 2000;93:546–549
  33. Tateishi A, Soejima Y, Taira Y, et al.  Feasibility of titration method of mild hypothermia in severely head-injured patients with intracranial hypertension. Neurosurgery. 1998;42:1065–1070
  34. Yamaguchi S, Nakayama K, Miyagi T, et al.  Neurochemical monitoring in the management of severe head-injured patients with hypothermia. Neurol Res. 2000;22:657–664
  35. Zhi DS, Zhang S, Zhou LG. Continuous monitoring of brain tissue oxygen pressure in patients with severe head injury during moderate hypothermia. Surg Neurol. 1999;52:393–396
  36. Marion DW, Penrod LE, Kelsey SF, et al.  Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med. 1997;336:540–546
  37. Shiozaki T, Sugimoto H, Taneda M, et al.  Selection of severely head injured patients for mild hypothermia therapy. J Neurosurg. 1998;89:206–211
  38. Shiozaki T, Kato A, Taneda M, et al.  Little benefit from mild hypothermia therapy for severely head injured patients with low intracranial pressure. J Neurosurg. 1999;91:185–191
  39. Shiozaki T, Hayakata T, Taneda M, et al.  A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. J Neurosurg. 2001;94:50–54
  40. Clifton GL, Miller ER, Choi SC, et al.  Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med. 2001;344:556–563
  41. Clifton G. Hypothermia and severe brain injury. J Neurosurg. 2000;93:718–719
  42. Narayan RK. Hypothermia for traumatic brain injury—a good idea proved ineffective. N Engl J Med. 2001;344:602–603
  43. Clifton GL, Choi SC, Miller ER, et al.  Intercenter variance in clinical trials of head trauma-experience of the national Acute Brain Injury Study: Hypothermia. J Neurosurg. 2001;95:751–755
  44. Martinez-Arizala A, Green BA. Hypothermia in spinal cord injury. J Neurotrauma. 1992;9(suppl 2):S497–S505
  45. Yu CG, Jimenez O, Marcillo AE, et al.  Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats. J Neurosurg. 2000;93(suppl 1):85–93
  46. Westergren H, Yu WR, Farooque M, et al.  Systemic hypothermia following spinal cord compression injury in the rat: axonal changes studied by beta-APP, ubiquitin, and PGP 9.5 immunohistochemistry. Spinal Cord. 1999;37:696–704
  47. Chatzipanteli K, Yanagawa Y, Marcillo AE, et al.  Posttraumatic hypothermia reduced polymorphonuclear leukocyte accumulation following spinal cord injury in rats. J Neurotrauma. 2000;17:321–332
  48. Dimar JR, Shields CB, Zhang YP, et al.  The role of directly applied hypothermia in spinal cord injury. Spine. 2000;25:2294–2302
  49. Kuchner EF, Hansebout RR, Pappius HM. Effects of dexamethasone and of local hypothermia on early and late tissue electrolyte changes in experimental spinal cord injury. J Spinal Cord. 2000;13:391–398
  50. Tator CH, Deecke L. Therapeutic value of local perfusion for acute spinal cord trauma. Trans Am Neurol Assoc. 1973;98:107–109
  51. Negrin J. Spinal cord hypothermia in the neurosurgical management of the acute and chronic post-traumatic paraplegic patient. Paraplegia. 1973;10:336–343
  52. Albin MS, White RJ. Therapeutic window after spinal cord trauma is longer than after spinal cord [letter] ischemia. Anesthesiology. 2000;92:281–282
  53. Dietrich DW, Busto R, Halley M, et al.  The importance of brain temperature in alterations of the blood-brain barrier following cerebral ischemia. J Neuropathol Exp Neurol. 1990;49:486–497
  54. Inamasu J, Suga S, Sato S, et al.  Intraischemic hypothermia attenuated intercellular adhesion molecule-1 (ICAM-1) and migration of neutrophil. Neurol Res. 2001;23:105–111
  55. Dietrich WD, Busto R, Alonso O, et al.  Intraischemic but not postischemic brain hypothermia protects chronically following global forebrain ischemia in rats. J Cereb Blood Flow Metab. 1993;13:541–549
  56. Colbourne F, Corbett D. Delayed and prolonged post-ischemic hypothermia is protective in the gerbil. Brain Res. 1994;654:265–272
  57. Reith J, Jorgensen HS, Pedersen PM, et al.  Body temperature in acute stroke: relation to stroke severity, infarct size, mortality, and outcome. Lancet. 1996;347:422–425
  58. Jorgensen HS, Reith J, Pedersen PM, et al.  Body temperature and outcome in stroke patients [letter]. Lancet. 1996;348:193
  59. Ginsberg MD, Busto R. Combating hyperthermia in acute stroke: a significant clinical concern. Stroke. 1998;29:529–534
  60. Kilpatrick MM, Lowry DW, Firlik AD, et al.  Hyperthermia in the neurosurgical intensive care unit. Neurosurgery. 2000;47:850–855
  61. Kammersgaard LP, Rasmussen BH, Jorgensen HS, et al.  Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: a case-control study: the Copenhagen Stroke Study. Stroke. 2000;31:2251–2256
  62. Kurokawa Y, Kano H, Yonemasu Y, et al.  Brain hypothermia relieves severe brain swelling following acute major cerebral artery occlusion. Neurol Med Chir (Tokyo). 2001;41:53–61
  63. Furlan A, Higashida R, Wechsler L, et al.  Intra-arterial prourokinase for acute ischemic stroke The PROACT study: a randomized controlled trial. JAMA. 1999;282:2003–2011
  64. Krieger DW, De Georgia MA, Abou-Chebl A, et al.  Cooling for acute ischemic brain damage (COOL AID): an open pilot study of induced hypothermia in acute ischemic stroke. Stroke. 2001;32:1847–1854
  65. Yamawaki T, Naritomi H, Nagatsuka K. Mild hypothermia in the management of severe cardioembolic stroke on hyperacute phase. Jpn J Stroke. 2000;22:440–446
  66. Yenari MA, Palmer JT, Bracci PM, et al.  Thrombolysis with tissue plasminogen activator is temperature dependent. Thromb Res. 1995;77:475–481
  67. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28:14–20
  68. Komatsu Y, Fujita K, Iguchi M, et al.  Mild hypothermia as a protective therapy for severe subarachnoid hemorrhage. Surg Cereb Stroke (Jpn). 2000;29:16–20
  69. Nagao S, Irie K, Kawai N, et al.  Protective effect of mild hypothermia on symptomatic vasospasm: a preliminary report. Acta Neurochir. 2000;76(suppl):547–550
  70. Piepgras A, Elste V, Frietsch T, et al.  Effect of moderate hypothermia on experimental severe subarachnoid hemorrhage, as evaluated by apparent diffusion coefficient changes. Neurosurgery. 2001;48:1128–1135
  71. Kawamura Y, Yamada K, Masago A, et al.  Hypothermia modulates induction of hsp70 and c-jun mRNA in the rat brain after subarachnoid hemorrhage. J Neurotrauma. 2000;17:243–250
  72. Thome C, Schubert G, Piepgras A, et al.  Hypothermia reduces acute vasospasm following SAH in rats. Acta Neurochir Suppl. 2001;77:255–258
  73. Kassell NF, Peerless SJ, Drake CG, et al.  Treatment of ischemic deficits from cerebral vasospasm with high dose barbiturate therapy. Neurosurgery. 1980;7:593–597
  74. Jinbo H, Dohi K, Nakamura Y, et al.  Fatal severe vasospasm due to rewarming following hypothermia. Neurol Med Chir (Tokyo). 2000;40:463–466
  75. Sagher O, Huang DL, Webb RC. Induction of hypercontractility in human cerebral arteries by rewarming following hypothermia: a possible role for tyrosine kinase. J Neurosurg. 1997;87:431–435
  76. Baker KZ, Young WL, Stone JG, et al.  Deliberate mild intraoperative hypothermia for craniotomy. Anesthesiology. 1994;81:361–367
  77. Hindman BJ, Todd MM, Gelb AW, et al.  Mild hypothermia as a protective therapy during intracranial aneurysm surgery: a randomized prospective pilot trial. Neurosurgery. 1999;44:23–32
  78. Karibe H, Sato K, Shimizu H, et al.  Intraoperative mild hypothermia ameliorates postoperative cerebral blood flow impairment in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2000;47:594–599
  79. Anonymous . Major ongoing stroke trials. Stroke. 2001;32:2448–2457
  80. Vaagenes P, Ginsberg M, Ebmeyer U, et al.  Cerebral resuscitation from cardiac arrest: pathophysiologic mechanisms. Crit Care Med. 1996;24(suppl):S57–S68
  81. Gisvold SE, Sterz F, Abramson NS, et al.  Cerebral resuscitation from cardiac arrest: treatment potentials. Crit Care Med. 1996;24(suppl 2):S69–S80
  82. Marion DW, Leonov Y, Ginsberg M, et al.  Resuscitative hypothermia. Crit Care Med. 1996;24(suppl 2):S81–S89
  83. Hicks SD, DeFranco DB, Callaway CW. Hypothermia during reperfusion after asphyxial cardiac arrest improves functional recovery and selectively alters stress-induced protein expression. J Cereb Blood Flow Metab. 2000;20:520–530
  84. Kawai K, Nakayama H, Tamura A. Limited but significant protective effect of hypothermia on ultra-early-type ischemic neuronal injury in the thalamus. J Cereb Blood Flow Metab. 1997;17:543–552
  85. Behringer W, Prueckner S, Safar P, et al.  Rapid induction of mild cerebral hypothermia by cold aortic flush achieves normal recovery in a dog outcome model with 20-minute exsanguination cardiac arrest. Acad Emerg Med. 2000;7:1341–1348
  86. Bernard SA, Jones BM, Horne MK. Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest. Ann Emerg Med. 1997;30:146–153
  87. Felberg RA, Krieger DW, Chuang R, et al.  Hypothermia after cardiac arrest: feasibility and safety of an external cooling protocol. Circulation. 2001;104:1799–1804
  88. Iwama H, Watanabe K, Shiraishi K, et al.  Mild hypothermia therapy after cardiopulmonary resuscitation may improve cerebral resuscitation [letter]. Can J Anaesth. 1997;44:677
  89. Holzer M, Behringer W, Schorkhuber W, et al.  Mild hypothermia and outcome after CPR. Hypothermia for Cardiac Arrest (HACA) Study Group. Acta Anaesthesiol Scand Suppl. 1997;111:55–58
  90. Sanada T, Ueki M, Tokudome M, et al.  Recovery from out-of-hospital cardiac arrest after mild hypothermia: report of two cases. Masui. 1998;47:742–745
  91. Gelman B, Schleinen CL, Lohe A, et al.  Selective brain cooling in infant piglets after cardiac arrest and resuscitation. Crit Care Med. 1996;24:1009–1017
  92. Rose C, Michalak K, Pannunzio M, et al.  Mild hypothermia delays the onset of coma and prevents brain edema and extracellular brain glutamate accumulation in rats with acute liver failure. Hepatology. 2000;31:872–877
  93. Jalan R, Damink SW, Deutz NE, et al.  Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure. Lancet. 1999;354:1164–1168
  94. Roberts DR, Manas D. Induced hypothermia in the management of cerebral oedema secondary to fulminant liver failure. Clin Transplant. 1999;13:545–547
  95. Jalan R, Olde Damink SW, Deutz NE, et al.  Restoration of cerebral blood flow autoregulation and reactivity to carbon dioxide in acute liver failure by hypothermia. Hepatology. 2001;34:50–54
  96. Blei A. Hypothermia for fulminant hepatic failure: a cool approach to a burning problem. Liver Transpl. 2000;6:245–247
  97. Blei AT. Hypothermia for hypertension [letter]. Lancet. 1999;354:2082
  98. Berger R, Garnier Y. Perinatal brain injury. J Perinat Med. 2000;28:261–285
  99. Bona E, Hagberg H, Loberg EM, et al.  Protective effects of moderate hypothermia after neonatal hypoxia-ischemia: short- and long-term outcome. Pediatr Res. 1998;43:738–745
  100. Thorensen M, Satas S, Lonberg EM, et al.  Twenty-four hours of mild hypothermia in unsedated newborn pigs starting after a severe global hypoxic-ischemic insult is not neuroprotective. Pediatr Res. 2001;50:405–411
  101. Gunn AJ, Gunn TR, de Haan HH, et al.  Dramatic neuronal rescue with prolonged selective head cooling after ischemia in fetal lambs. J Clin Invest. 1997;99:248–256
  102. Yokota S, Imagawa T, Miyamae T, et al.  Hypothetical pathophysiology of acute encephalopathy and encephalitis related to influenza virus infection and hypothermia therapy. Pediatr Int. 2000;42:197–203
  103. Aibiki M, Maekawa S, Ogura S, et al.  Effect of moderate hypothermia on systemic and internal jugular plasma IL-6 levels after traumatic brain injury in humans. J Neurotrauma. 1999;16:225–232
  104. Irazuzta JE, Pretzlaff R, Rowin M, et al.  Hypothermia as an adjunctive treatment for severe bacterial meningitis. Brain Res. 2000;881:88–97
  105. Gunn AJ. Cerebral hypothermia for prevention of brain injury following perinatal asphyxia. Curr Opin Pediatr. 2000;12:111–115
  106. Wagner CL, Eicher DJ, Katikaneli LD, et al.  The use of hypothermia: a role in the treatment of neonatal asphyxia?. Pediatr Neurol. 1999;21:429–443
  107. Azzopardi D, Robertson NJ, Cowan FM, et al.  Pilot study of treatment with whole body hypothermia for neonatal encephalopathy. Pediatrics. 2000;106:684–694
  108. Corrard F. Selective brain cooling. Arch Pediatr. 1999;6:87–92
  109. Thoresen M, Whitelaw A. Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxicischemic encephalopathy. Pediatrics. 2000;106:92–99
  110. Nakashita Y, Aoki M. Mild brain hypothermia for influenza encephalitis/encephalopathy and its significance. Nippon Rinsho. 2000;58:2333–2337
  111. Munakata M, Kato R, Yokoyama H, et al.  Combined therapy with hypothermia and anticytokine agents in influenza A encephalopathy. Brain Dev. 2000;22:373–377
  112. Ohtsuki N, Kimura S, Nezu A, et al.  Effects of mild hypothermia and steroid pulse combination therapy on acute encephalopathy associated with influenza virus infection: report of two cases. No To Hattatsu. 2000;32:318–322

☆ Address for reprints: Joji Inamasu, MD, Department of Emergency Medicine, National Tokyo Medical Center, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan; +81-3-3411-0111, fax +81-3-3418-3380; Email GInamasu@aol.com.

PII: S0196-0644(02)00033-1

doi: 10.1067/mem.2002.123697

Annals of Emergency Medicine
Volume 40, Issue 2 , Pages 220-230 , August 2002

Article Tools