Mild hypothermia as a treatment for central nervous system injuries Positive or negative effects?

Neural Regeneration Research, 2013 · DOI: 10.3969/j.issn.1673-5374.2013.28.010 · Published: October 1, 2013

Simple Explanation

Central nervous system injuries can lead to brain edema, ischemia, oxidative stress, excitotoxicity, and dysregulation of calcium homeostasis, potentially worsening the initial damage. Hypothermia has shown promise in treating acute central nervous system injuries, particularly high intracranial pressure after traumatic brain injuries, and improving survival and quality of life after ischemic events. Hypothermia's potential benefits include reducing free radical production, inflammation, excitotoxicity, and intracranial pressure, thus protecting the central nervous system from further damage.

Study Duration

Not specified

Participants

Animal models and human clinical studies

Evidence Level

Review

Key Findings

1
Mild hypothermia shows promise as a novel treatment for brain and spinal cord injuries, supported by growing data.
2
Mild to moderate hypothermia improves outcomes in models of both cervical and thoracic spinal cord injury.
3
Hypothermia has been reported to reduce the degree of diffuse axonal damage in models of traumatic brain injury

Research Summary

Therapeutic hypothermia is considered a promising treatment strategy for brain and spinal cord injuries, with experimental and clinical work supporting its effectiveness. The mechanisms underlying hypothermia's protective effects involve various factors, including reduced cerebral metabolism, interrupted apoptotic pathways, improved ion homeostasis, and attenuated inflammation. While hypothermia can induce physiological changes and side effects, such as circulatory and cardiovascular alterations, electrolyte disorders, and increased infection risk, these can be managed with careful monitoring and intervention.

Practical Implications

Clinical Application

Hypothermia can be considered for patients with acute brain and spinal cord injuries to improve survival and neurological outcomes.

Temperature Management Strategies

Future studies should focus on determining optimal hypothermia protocols, including target temperature ranges and treatment duration, to maximize benefits and minimize risks.

Side Effect Management

Clinicians should be vigilant in monitoring and managing potential side effects of hypothermia, such as electrolyte imbalances, infection risk, and clotting disorders.

Study Limitations

1
Controversies still exist regarding hypothermic efficacy as well as the mechanisms by which mild hypothermia may protect the brain after trauma
2
Potential side effects, such as circulatory and cardiovascular alterations and electrolyte disorders, need careful management
3
The ideal hypothermia protocols, including target temperature ranges and treatment duration, are yet to be fully determined.

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