PDF herunterladen
Indian Journal of Neurosurgery 2014; 03(03): 138-143
DOI: 10.4103/2277-9167.146827
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Hypothermia for neuroprotection in severe traumatic brain injury

Sumit Sinha
,
Nasim Mansoori
Verantwortlicher Herausgeber dieser Rubrik:
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
18. Januar 2017 (online)

  als PDF herunterladen  Lizenzen und Reprints

Abstract

Traumatic brain injury (TBI) is a common cause of morbidity and mortality worldwide. There has been a constant search for therapeutic modalities in an attempt to reduce this burden, but till date, none of them have proved to have a significant clinical impact. The interest in whole-body hypothermia as a treatment modality for severe TBI arose from enthusiastic experiences with the patients having anoxic brain damage after cardiac arrest. However, despite numerous randomised controlled trials (RCTs) and systematic reviews, its role in improving the outcomes after TBI are still far from being certain to warrant its clinical usage. The concept that hypothermia may be beneficial in improving the outcomes after TBI evolved with the discovery that the final neuronal injury pattern after an ischemic event could be lessened by cooling the brain. Several subsequent animal studies and clinical trials have now been conducted, which have led the Brain Trauma Foundation to issue a Level III recommendation for the use of primary therapeutic hypothermia in the management of TBI. Induced hypothermia should logically be useful in improving the mortality and neurologic outcome after severe TBI. However, the beneficial, effect of hypothermia only exists in high-quality trials, and presently, there is no Level I or Level II evidence. The relative scarcity of high-quality data in this setting entails well-designed large multicentric RCT’s to prove any association if it exists.

Key words

Hypothermia - mortality - neuroprotection - outcome - traumatic brain injury
 

  • References

  • 1 Wang H, Olivero W, Wang D, Lanzino G. Cold as a therapeutic agent. Acta Neurochir (Wien) 2006; 148: 565-570
    CrossrefPubMedGoogle Scholar
  • 2 Polderman KH. Application of therapeutic hypothermia in the ICU: Opportunities and pitfalls of a promising treatment modality. Part 1: Indications and evidence. Intensive Care Med 2004; 30: 556-575
    CrossrefPubMedGoogle Scholar
  • 3 Fay T. Observations on generalized refrigeration in cases of severe cerebral trauma. Res Public Assoc Res Nerv Dis 1945; 4: 611-619
    PubMedGoogle Scholar
  • 4 Rosomoff HL, Holaday DA. Cerebral blood flow and cerebral oxygen consumption during hypothermia. Am J Physiol 1954; 179: 85-88
    PubMedGoogle Scholar
  • 5 Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002; 346: 549-556
    CrossrefPubMedGoogle Scholar
  • 6 Cheung KW, Green RS, Magee KD. Systematic review of randomized controlled trials of therapeutic hypothermia as a neuroprotectant in post cardiac arrest patients. CJEM 2006; 8: 329-337
    CrossrefPubMedGoogle Scholar
  • 7 Dietrich WD, Bramlett HM. The evidence for hypothermia as a neuroprotectant in traumatic brain injury. Neurotherapeutics 2010; 7: 43-50
    CrossrefPubMedGoogle Scholar
  • 8 Brain Trauma Foundation, American Association of Neurological Surgeons. Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007; 4: S1-S106
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 9 Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Crit Care Med 2009; 37: S186-S202
    CrossrefPubMedGoogle Scholar
  • 10 Erecinska M, Thoresen M, Silver IA. Effects of hypothermia on energy metabolism in Mammalian central nervous system. J Cereb Blood Flow Metab 2003; 23: 513-530
    CrossrefPubMedGoogle Scholar
  • 11 Zhao QJ, Zhang XG, Wang Lx. Mild hypothermia therapy reduces blood glucose and lactate and improves neurologic outcomes in patients with severe traumatic brain injury. J Crit Care 2011; 26: 311-315
    CrossrefPubMedGoogle Scholar
  • 12 Wang Q, Li AL, Zhi DS, Huang HL. Effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury. Chin J Traumatol 2007; 10: 246-249
    PubMedGoogle Scholar
  • 13 Yenari MA, Han HS. Neuroprotective mechanisms of hypothermia in brain ischaemia. Nat Rev Neurosci 2012; 13: 267-278
    CrossrefPubMedGoogle Scholar
  • 14 Nakashima K, Todd MM. Effects of hypothermia on the rate of excitatory amino acid release after ischemic depolarization. Stroke 1996; 27: 913-918
    CrossrefPubMedGoogle Scholar
  • 15 Wang D, Zhao Y, Zhang Y, Zhang T, Shang X, Wang J. et al Hypothermia protects against oxygen-glucose deprivation-induced neuronal injury by down-regulating the reverse transport of glutamate by astrocytes as mediated by neurons. Neuroscience 2013; 237: 130-138
    CrossrefPubMedGoogle Scholar
  • 16 Mueller-Burke D, Koehler RC, Martin LJ. Rapid NMDA receptor phosphorylation and oxidative stress precede striatal neurodegeneration after hypoxic ischemia in newborn piglets and are attenuated with hypothermia. Int J Dev Neurosci 2008; 26: 67-76
    CrossrefPubMedGoogle Scholar
  • 17 Xiong M, Yang Y, Chen GQ, Zhou WH. Post-ischemic hypothermia for 24h in P7 rats rescues hippocampal neuron: Association with decreased astrocyte activation and inflammatory cytokine expression. Brain Res Bull 2009; 79: 351-357
    CrossrefPubMedGoogle Scholar
  • 18 Nunnally ME, Jaeschke R, Bellingan GJ, Lacroix J, Mourvillier B, Rodriguez-Vega GM. et al Targeted temperature management in critical care: A report and recommendations from five professional societies. Crit Care Med 2011; 39: 1113-1125
    CrossrefPubMedGoogle Scholar
  • 19 Giraud R, Siegenthaler N, Bendjelid K. Cardiac index during therapeutic hypothermia: Which target value is optimal?. Crit Care 2013; 17: 214
    CrossrefPubMedGoogle Scholar
  • 20 Inamasu J, Nakatsukasa M, Mayanagi K, Miyatake S, Sugimoto K, Hayashi T. et al Subarachnoid hemorrhage complicated with neurogenic pulmonary edema and takotsubo-like cardiomyopathy. Neurol Med Chir (Tokyo) 2012; 52: 49-55
    CrossrefPubMedGoogle Scholar
  • 21 Hoesch RE, Lin E, Young M, Gottesman RF, Altaweel L, Nyquist PA. et al Acute lung injury in critical neurological illness. Crit Care Med 2012; 40: 587-593
    CrossrefPubMedGoogle Scholar
  • 22 Seule MA, Muroi C, Mink S, Yonekawa Y, Keller E. Therapeutic hypothermia in patients with aneurysmal subarachnoid hemorrhage, refractory intracranial hypertension, or cerebral vasospasm. Neurosurgery 2009; 64: 86-92
    CrossrefPubMedGoogle Scholar
  • 23 Polderman KH, Tjong Tjin Joe R, Peerdeman SM, Vandertop WP, Girbes AR. Effects of therapeutic hypothermia on intracranial pressure and outcome in patients with severe head injury. Intensive Care Med 2002; 28: 1563-1573
    CrossrefPubMedGoogle Scholar
  • 24 Tokutomi T, Miyagi T, Morimoto K, Karukaya T, Shigemori M. Effect of hypothermia on serum electrolyte, inflammation coagulation, and nutritional parameters in patients with severe traumatic brain injury. Neurocrit Care 2004; 1: 171-182
    CrossrefPubMedGoogle Scholar
  • 25 Zhou J, Poloyac SM. The effect of therapeutic hypothermia on drug metabolism and response: Cellular mechanisms to organ function. Expert Opin Drug Metab Toxicol 2011; 7: 803-816
    CrossrefPubMedGoogle Scholar
  • 26 Clifton GL, Allen S, Barrodale P, Plenger P, Berry J, Koch S. et al A phase II study of moderate hypothermia in severe brain injury. J Neurotrauma 1993; 10: 263-271
    CrossrefPubMedGoogle Scholar
  • 27 Marion DW, Obrist WD, Carlier PM, Penrod LE, Darby JM. The use of moderate therapeutic hypothermia for patients with severe head injuries: A preliminary report. J Neurosurg 1993; 79: 354-362
    CrossrefPubMedGoogle Scholar
  • 28 Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith Jr KR. et al Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344: 556-563
    CrossrefPubMedGoogle Scholar
  • 29 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
    CrossrefPubMedGoogle Scholar
  • 30 Jiang JY, Xu W, Li WP, Gao GY, Bao YH, Liang YM. et al Effect of long-term mild hypothermia or short-term mild hypothermia on outcome of patients with severe traumatic brain injury. J Cereb Blood Flow Metab 2006; 26: 771-776
    CrossrefPubMedGoogle Scholar
  • 31 Qiu W, Zhang Y, Sheng H, Zhang J, Wang W, Liu W. et al Effects of therapeutic mild hypothermia on patients with severe traumatic brain injury after craniotomy. J Crit Care 2007; 22: 229-235
    CrossrefPubMedGoogle Scholar
  • 32 Shiozaki T, Nakajima Y, Taneda M, Tasaki O, Inoue Y, Ikegawa H. et al Efficacy of moderate hypothermia in patients with severe head injury and intracranial hypertension refractory to mild hypothermia. J Neurosurg 2003; 99: 47-51
    CrossrefPubMedGoogle Scholar
  • 33 Yan Y, Tang W, Deng Z, Zhong D, Yang G. Cerebral oxygen metabolism and neuroelectrophysiology in a clinical study of severe brain injury and mild hypothermia. J Clin Neurosci 2010; 17: 196-200
    CrossrefPubMedGoogle Scholar
  • 34 Clifton GL, Valadka A, Zygun D, Coffey CS, Drever P, Fourwinds S. 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: 131-139
    CrossrefPubMedGoogle Scholar
  • 35 Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S. 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
    CrossrefPubMedGoogle Scholar
  • 36 Adelson PD, Ragheb J, Kanev P, Brockmeyer D, Beers SR, Brown SD. et al Phase II clinical trial of moderate hypothermia after severe traumatic brain injury in children. Neurosurgery 2005; 56: 740-754
    CrossrefPubMedGoogle Scholar
  • 37 Hutchison JS, Ward RE, Lacroix J, Hébert PC, Barnes MA, Bohn DJ. et al Hypothermia therapy after traumatic brain injury in children. N Engl J Med 2008; 358: 2447-2456
    CrossrefPubMedGoogle Scholar
  • 38 Qju WS, Liu WG, Shen H, Wang WM, Hang ZL, Zhang Y. et al Therapeutic effect of mild hypothermia on severe traumatic head injury. Chin J Traumatol 2005; 8: 27-32
    PubMedGoogle Scholar
  • 39 Smrcka M, Vidlak M, Maca K, Smrcka V, Gal R. The influence of mild hypothermia on ICP, CPP and outcome in patients with primary and secondary brain injury. Acta Neurochir Suppl 2005; 95: 273-275
    PubMedGoogle Scholar
  • 40 Zhi D, Zhang S, Lin X. Study on therapeutic mechanism and clinical effect of mild hypothermia in patients with severe head injury. Surg Neurol 2003; 59: 381-385
    CrossrefPubMedGoogle Scholar
  • 41 Alderson P, Gadkary C, Signorini DF. Therapeutic hypothermia for head injury. Cochrane Database Syst Rev 2002; (01) CD001048
    PubMedGoogle Scholar
  • 42 Fox JL, Vu EN, Doyle-Waters M, Brubacher JR, Abu-Laban R, Hu Z. Prophylactic hypothermia for traumatic brain injury: A quantitative systematic review. CJEM 2010; 12: 355-364
    CrossrefPubMedGoogle Scholar
  • 43 Harris OA, Colford Jr JM, Good MC, Matz PG. The role of hypothermia in the management of severe brain injury: A meta-analysis. Arch Neurol 2002; 59: 1077-1083
    CrossrefPubMedGoogle Scholar
  • 44 Henderson WR, Dhingra VK, Chittock DR, Fenwick JC, Ronco JJ. Hypothermia in the management of traumatic brain injury. A systematic review and meta-analysis. Intensive Care Med 2003; 29: 1637-1644
    CrossrefPubMedGoogle Scholar
  • 45 McIntyre LA, Fergusson DA, Hébert PC, Moher D, Hutchison JS. Prolonged therapeutic hypothermia after traumatic brain injury in adults: A systematic review. JAMA 2003; 289: 2992-2999
    CrossrefPubMedGoogle Scholar
  • 46 Peterson K, Carson S, Carney N. Hypothermia treatment for traumatic brain injury: A systematic review and meta-analysis. J Neurotrauma 2008; 25: 62-71
    CrossrefPubMedGoogle Scholar
  • 47 Sydenham E, Roberts I, Alderson P. Hypothermia for traumatic head injury. Cochrane Database Syst Rev 2009;CD001048.
    PubMed
  • 48 Higgins JP. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. The Cochrane Collaboration. 2011 Available from: http://www.handbook.cochrane.org/ . [Last accessed on 2011 Apr 06].
    PubMedGoogle Scholar
  • 49 Georgiou AP, Manara AR. Role of therapeutic hypothermia in improving outcome after traumatic brain injury: A systematic review. Br J Anaesth 2013; 110: 357-367
    CrossrefPubMedGoogle Scholar
  • 50 Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J. et al GRADE guidelines: 1, Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 2011; 64: 383-394
    CrossrefPubMedGoogle Scholar
  • 51 Qiu L. Hypothermia in traumatic brain injury - A literature review. J Intensive Care Soc 2011; 12: 201-214
    PubMedGoogle Scholar
  • 52 Wilson JT, Pettigrew LE, Teasdale GM. Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: Guidelines for their use. J Neurotrauma 1998; 15: 573-585
    CrossrefPubMedGoogle Scholar
  • 53 Cooper J. The prophylactic hypothermia trial to lessen traumatic brain injury – Randomised controlled trial (The Polar RCT). Personal Communication. Identifier: NCT00987688. ANZIC Research Centre; 2010. p. 1-67. Available from: http://www.Clinicaltrials.gov
    PubMed
  • 54 Andrews PJ, Sinclair HL, Battison CG, Polderman KH, Citerio G, Mascia L. et al European society of intensive care medicine study of therapeutic hypothermia (32-35°C) for intracranial pressure reduction after traumatic brain injury (the Eurotherm3235Trial). Trials 2011; 12: 8
    CrossrefPubMedGoogle Scholar