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Therapeutic hypothermia translates from ancient history in to practice

Gunn, AJ; Laptook, AR; Robertson, NJ; Barks, JD; Thoresen, M; Wassink, G; Bennet, L; (2017) Therapeutic hypothermia translates from ancient history in to practice. Pediatric Research , 81 (1-2) pp. 202-209. 10.1038/pr.2016.198. Green open access

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Abstract

Acute postasphyxial 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 y 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 ~6 h, only to die hours to days later during a “secondary” deterioration phase 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 midchildhood.

Type: Article
Title: Therapeutic hypothermia translates from ancient history in to practice
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/pr.2016.198
Publisher version: http://dx.doi.org/10.1038/pr.2016.198
Language: English
Additional information: Copyright © 2016 International Pediatric Research Foundation, Inc.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology
URI: https://discovery.ucl.ac.uk/id/eprint/1520021
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