Therapeutic hypothermia translates from ancient history in to practice
Acute post-asphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a “dream revisited”. In this review, a historical perspective is provided from the first reported us...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5233584/ https://www.ncbi.nlm.nih.gov/pubmed/27673420 http://dx.doi.org/10.1038/pr.2016.198 |
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author | Gunn, Alistair J. Laptook, Abbot R. Robertson, Nicola J. Barks, John D. Thoresen, Marianne Wassink, Guido Bennet, Laura |
author_facet | Gunn, Alistair J. Laptook, Abbot R. Robertson, Nicola J. Barks, John D. Thoresen, Marianne Wassink, Guido Bennet, Laura |
author_sort | Gunn, Alistair J. |
collection | PubMed |
description | Acute post-asphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a “dream revisited”. In this review, a historical perspective is provided from the first reported use of therapeutic hypothermia for brain injuries in antiquity, to the present day. The first uncontrolled trials of cooling for resuscitation were reported more than 50 years ago. The seminal insight that led to the modern revival of studies of neuroprotection was that after profound asphyxia, many brain cells show initial recovery from the insult during a short “latent” phase, typically lasting approximately 6 h, only to die hours to days later after a “secondary” deterioration characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Studies designed around this conceptual framework showed that mild hypothermia initiated as early as possible before the onset of secondary deterioration, and continued for a sufficient duration to allow the secondary deterioration to resolve, is associated with potent, long-lasting neuroprotection. There is now compelling evidence from randomized controlled trials that mild induced hypothermia significantly improves intact survival and neurodevelopmental outcomes to mid-childhood. |
format | Online Article Text |
id | pubmed-5233584 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
record_format | MEDLINE/PubMed |
spelling | pubmed-52335842017-03-27 Therapeutic hypothermia translates from ancient history in to practice Gunn, Alistair J. Laptook, Abbot R. Robertson, Nicola J. Barks, John D. Thoresen, Marianne Wassink, Guido Bennet, Laura Pediatr Res Article Acute post-asphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a “dream revisited”. In this review, a historical perspective is provided from the first reported use of therapeutic hypothermia for brain injuries in antiquity, to the present day. The first uncontrolled trials of cooling for resuscitation were reported more than 50 years ago. The seminal insight that led to the modern revival of studies of neuroprotection was that after profound asphyxia, many brain cells show initial recovery from the insult during a short “latent” phase, typically lasting approximately 6 h, only to die hours to days later after a “secondary” deterioration characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Studies designed around this conceptual framework showed that mild hypothermia initiated as early as possible before the onset of secondary deterioration, and continued for a sufficient duration to allow the secondary deterioration to resolve, is associated with potent, long-lasting neuroprotection. There is now compelling evidence from randomized controlled trials that mild induced hypothermia significantly improves intact survival and neurodevelopmental outcomes to mid-childhood. 2016-09-27 2017-01 /pmc/articles/PMC5233584/ /pubmed/27673420 http://dx.doi.org/10.1038/pr.2016.198 Text en http://www.nature.com/authors/editorial_policies/license.html#terms Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Gunn, Alistair J. Laptook, Abbot R. Robertson, Nicola J. Barks, John D. Thoresen, Marianne Wassink, Guido Bennet, Laura Therapeutic hypothermia translates from ancient history in to practice |
title | Therapeutic hypothermia translates from ancient history in to practice |
title_full | Therapeutic hypothermia translates from ancient history in to practice |
title_fullStr | Therapeutic hypothermia translates from ancient history in to practice |
title_full_unstemmed | Therapeutic hypothermia translates from ancient history in to practice |
title_short | Therapeutic hypothermia translates from ancient history in to practice |
title_sort | therapeutic hypothermia translates from ancient history in to practice |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5233584/ https://www.ncbi.nlm.nih.gov/pubmed/27673420 http://dx.doi.org/10.1038/pr.2016.198 |
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