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Depth of delayed cooling alters neuroprotection pattern after hypoxia-ischemia

Iwata, O; Thornton, JS; Sellwood, MW; Iwata, S; Sakata, Y; Noone, MA; ... Robertson, NJ; + view all (2005) Depth of delayed cooling alters neuroprotection pattern after hypoxia-ischemia. ANN NEUROL , 58 (1) 75 - 87. 10.1002/ana.20528.

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Abstract

Hypothermia after perinatal hypoxia-ischemia (HI) is neuroprotective; the precise brain temperature that provides optimal protection is unknown. To assess the pattern of brain injury with 3 different rectal temperatures, we randomized 42 newborn piglets: (Group i) sham-normothermia (38.5-39 degrees C); (Group ii) sham-33 degrees C; (Group iii) HI-normothermia; (Group iv) HI-35 degrees C; and (Group v) HI-33 degrees C. Groups iii through v were subjected to transient HI insult. Groups ii, iv, and v were cooled to their target rectal temperatures between 2 and 26 hours after resuscitation. Experiments were terminated at 48 hours. Compared with normothermia, hypothermia at 35 degrees C led to 25 and 39% increases in neuronal viability in cortical gray matter (GM) and deep GM, respectively (both p < 0.05); hypothermia at 33 degrees C resulted in a 55% increase in neuronal viability in cortical GM (p < 0.01) but no significant increase in neuronal viability in deep GM. Comparing hypothermia at 35 and 33 degrees C, 35 degrees C resulted in more viable neurons in deep GM, whereas 33 degrees C resulted in more viable neurons in cortical GM (both p < 0.05). These results suggest that optimal neuroprotection by delayed hypothermia may occur at different temperatures in the cortical and deep GM. To obtain maximum benefit, you may need to design patient-specific hypothermia protocols by combining systemic and selective cooling.

Type:Article
Title:Depth of delayed cooling alters neuroprotection pattern after hypoxia-ischemia
DOI:10.1002/ana.20528
Keywords:MAGNETIC-RESONANCE-SPECTROSCOPY, MILD SYSTEMIC HYPOTHERMIA, CEREBRAL ENERGY FAILURE, CARBON-DIOXIDE TENSION, TISSUE OXYGEN-TENSION, BRAIN-INJURY, MODERATE HYPOTHERMIA, POSTISCHEMIC HYPOTHERMIA, NEONATAL ENCEPHALOPATHY, PERINATAL ASPHYXIA
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Women's Health > Maternal and Fetal Medicine
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Women's Health > Neonatology
UCL > School of BEAMS > Faculty of Engineering Science > Medical Physics and Bioengineering

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