Synopses & Reviews
The International Brain Hypothermia Symposium 2004, held in Tokyo, was a forum for many of the world's leading researchers and clinicians to present and discuss developments on the cutting edge of this most promising of neurological therapies. With a view to sharing this knowledge and encouraging the spread of new techniques, the editors have compiled these proceedings covering the latest technology and methods. Topics include brain thermo-pooling, hemoglobin-dysfunction-associated neuronal hypoxia, intensive care management of brain hypothermia for severely brain-injured patients, new findings not yet recorded in animal models, and control of hypothermia-associated immune crises. Also included are advanced clinical results from trauma, stroke, and cardiac arrest patients. The result is a volume that will be a valuable resource for professionals in the fields of emergency treatment, critical medicine, and neurosurgery.
Synopsis
The International Brain Hypothermia Symposium 2004was the second time I have had the honor of opening such a gathering on brain hypothermia treatment. It was a great pleasure to greet the participants in the hope that their valuablecontributions would make the Tokyo meeting memorable. Brainhypothermia has long been seen as a promising method that may overcome current limitations on brain resuscitation in patients with severe brain damage. However, although excellentresults have been obtained in experimental animal models, for some reason brain hypothermia has not alwaysbeen successful clinically, and resolving this problem has been a major challenge facing physicians specializing in brain therapies. The ICUmanagement of recent research has uncovered newmechanisms ofbrain damage not seen in animal models, including brain thermo-pooling at temperatures above 40C in severe brain damage, masking neuronal hypoxia even with normal cerebral blood flow. Stress-related hyper- glycemia with brain hypothermia was expected to generate useful results in patients with external injuries, cerebral occlusive stroke, and cardiac arrest. In recent clinical studies of brain hypothermia treatment, many excellent results began being reported on the manage- ment of severe brain injury, ischemic stroke, and post-resuscitation after cardiac arrest. However, in clinical brain hypothermia treatment many questions remained about appro- priate treatment targets, leu management technique, prevention of complications, control of brain tissue temperature, management of hypothermia insult, and mechanisms underly- ing the onset of vegetative states.
Table of Contents
1. Opening the Door to Hypothermia Historical Review of the Development of Brain Hypothermia 2. Up-to-date Basic Science of Hypothermia A Review of the Protective Effects of Hypothermia on the Axonal and Vascular Pathobiology Associated with Traumatic Brain Injury Factors Regulating Hypothermic Protection in Experimental Models of Brain Injury Effects of Brain Hypothermia on Brain Edema Formation After Intracerebral Hemorrhage in Rats Hypothermia Prolongs Survival Time of Severely Septic Rats: A Study Using a Computer-Supported Multichannel Thermoregulatory System Influence of Hypothermia on Neuroprotective Effect of Inhibiting Neurotransmitters and Agonists of Their Receptors 3. Development of Brain Hypothermia Treatment A New Concept of Brain Hypothermia Treatment and Pitfalls in Intensive Care Unit Hypothermia Management 4. Technique and ICU Management of Brain Hypothermia Is Hypothermia Beneficial by Preventing Fever? Management of Induced Hypothermia in the Intensive Care Unit Microdialysis for Time Course of Extracellular Glutamate in Poor-Grade Aneurysm Patients: Preliminary Study Mild Brain Hypothermia Suppresses Oxygen Free Radicals in Patients with Neuroemergency: An Ex Vivo Electron Spin Resonance Study Mathematical Analysis of Extremity Immersion Cooling for Brain Temperature Management Rapid Induction of Brain Hypothermia by Selective Intra-Arterial Perfusion of Crystalloid Solution in an Animal Model Combination of Forced Air Cooling, Cooling by Circulating Water Mattress, and Intravenous Bolus Infusion of Iced Saline Is an Effective and Safe Technique for Induction of Mild Hypothermia During Cerebral Aneurysm Surgery Automatic Air-Cooling Incubating System for Brain Hypothermia Treatment Automatic Temperature Management System in Patients with Mild Hypothermia: Three Case Reports Intraoperative Mild Hypothermia in Neurosurgery The Importance of Nursing Management in the Treatment of Brain Hypothermia 5. Hypothermia Response Moderate Hypothermia Attenuates the Endothelium-Dependent Pial Arteriole Dilatation but Not the Endothelium-Independent Response in Rats Pial Microcirculation Evaluated by Closed Cranial Window Method 7 Days After Impact Acceleration Injury in Rats: Does Post-Traumatic Hypothermia Provide Persisting Pial Vascular Protection? 6. Neonate and Pediatric Brain Hypothermia Hypothermia Following Traumatic Brain Injury in Children Clinical Study of Brain Magnetic Resonance Images in Infants with Brain Hypothermia Study on Body Temperature Monitoring During Brain Hypothermia in Newborn Infants with Severe Hypoxic-Ischemic Encephalopathy Neuropsychological Recovery in Pediatric Patients with Acute Subdural Hematoma Treated with Mild Hypothermia Therapy: Report of Two Cases Adjunctive Therapy Application of Hyperbaric Oxygen Therapy in Children Already Treated with Mild Hypothermia for Disturbance of Consciousness 7. Experimental Research and Clinical Management The Management of Cerebral Stroke by Brain Hypothermia Treatment The Nordic Cooling Stroke Study--NOCSS. A Multicenter Study of Induced Mild Hypothermia in Acute Stroke Patients. Ongoing Clinical Trial Hypothermia in the Therapy of Ischemic Stroke Correlation of Hypothermia with Decrease of Glutathione Concentration and Tolerance to Cerebral Ischemia Hypothermia Prolongs the Viability of Ischemic Brain Tissue Due to Neuroprotection Linked to Redistribution of Oxygen in Brain: Positron Emission Tomography Study of the Critical First 6h After Stroke in Pigs Neuroprotective Effects of Selective Brain Hypothermia (SBH) on Permanent Focal Cerebral Ischemia in Rats The Effects of Mild and Deep Hypothermia on the Neuronal Activity and Energy Metabolism in Brain Slices In Vitro Ultra-Early Induction of Brain Hypothermia for Patients with Poor-Grade Subarachnoid Hemorrhage Brain Temperature in Patients with Chronic Hydrocephalus After Subarachnoid Hemorrhage The Influence of Mild Hypothermia on the Incidence of Vasospasms in Patients After Severe Subarachnoid Hemorrhage Evaluation of Results of Transcranial Doppler Ultrasonography in Postoperative Brain Hypothermia Therapy for Severe Cases of Subarachnoid Hemorrhage Body Temperature in Stroke: Secondary Stress Phenomenon or Causal Relationship? Important Regional Differences in Brain Tissue Susceptibility to Secondary Damage After Traumatic Brain Injury A Randomized Clinical Trial of Therapeutic Hypothermia in Severe Head-Injured Patients in Japan: Overview of the Protocol The Use of Mild Hypothermia in the Prevention of Secondary Brain Injury Hypothermia May Attenuate Not Only Interleukin-6 but also Matrix Metalloproteinase-9 of Systemic and Internal Jugular Blood from the Inflammatory Response to Traumatic Brain Injury in Humans Immune-Enhancing Effect of Arginine on Patients with Severe Traumatic Brain Injuries Who Have Undergone Therapeutic Brain Hypothermia Management of Patients with Traumatic Brain Injury: Hypothermia Therapy and the Importance of Temperature Management Evaluation of Cerebral and Systemic Flow/Metabolism During Brain Hypothermia Therapy Novel Potentials for Emergency Hypothermia: Suspended Animation with Delayed Resuscitation from Exsanguination Cardiac Arrest Resuscitative Hypothermia in Comatose Survivors After Prolonged Cardiopulmonary Resuscitation and B-type Natriuretic Peptide for the Advanced Challenge Survival After Subarachnoid Hemorrhage Using Brain Hypothermia After Recovery of Spontaneous Circulation from Cardiopulmonary Arrest: A Case Report Indication of Brain Hypothermic Therapy in Cardiac Arrest Brain Hypothermic Therapy Following Cardiopulmonary Bypass for Cardiac Arrest Patients Who Did Not Respond to Advanced Cardiovascular Life Support Advanced Challenge in Resuscitative Hypothermia in Patients with Cardiac Arrest on Arrival at the Emergency Room Influence of Brain Hypothermia on Blood Interleukin-6 Levels on Postresuscitated Patients After Cardiac Arrest Changes of Blood Glutamate Levels in Hypoxic Ischemic Encephalopathy Patients Undergoing Brain Hypothermia 8. Preventing Persistent Vegetation Persistent Vegetation Means Unconsciousness? How to Manage Vegetation and Memory Disturbances Following Severe Brain Damage Significance of Musico-Kinetic Therapy for Patients with Brain Injury Following Therapeutic Hypothermia