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Depth of delayed cooling alters neuroprotection pattern after hypoxia-ischemia

Iwata, O.; Thornton, J.S.; Sellwood, M.W.; Iwata, S.; Sakata, Y.; Noone, M.A.; ... Robertson, N.J.; + view all (2005) Depth of delayed cooling alters neuroprotection pattern after hypoxia-ischemia. Annals of Neurology , 58 (1) pp. 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°C); (Group ii) sham-33°C; (Group iii) HI-normothermia; (Group iv) HI-35°C; and (Group v) HI-33°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°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°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°C, 35°C resulted in more viable neurons in deep GM, whereas 33°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
Publisher version:http://www3.interscience.wiley.com/cgi-bin/abstract/110550042/ABSTRACT
Language:English
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology > Molecular Neuroscience
UCL > School of BEAMS > Faculty of Engineering Science > Medical Physics and Bioengineering

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