Mechanisms of hypothermic neuroprotection.
There is now compelling clinical evidence that prolonged, moderate cerebral hypothermia initiated within a few hours after severe hypoxia-ischemia and continued until resolution of the acute phase of delayed cell death can reduce subsequent neuronal loss and improve behavioral recovery in term infants and adults after cardiac arrest. Perhaps surprisingly, the specific mechanisms of hypothermic neuroprotection remain unclear, at least in part because hypothermia suppresses a broad range of potential injurious factors. In the present review we critically examine proposed mechanisms in relation to the known window of opportunity for effective protection with hypothermia. Better knowledge of the mechanisms of hypothermia is critical to help guide the rational development of future combination treatments to augment neuroprotection with hypothermia, and to identify those most likely to benefit from it.
Drury
Paul P
PP
Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Bennet
Laura
L
Gunn
Alistair J
AJ
D000328:Adult; D001238:Asphyxia Neonatorum / Q000150:complications*; D001831:Body Temperature; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009410:Nerve Degeneration / Q000517:prevention & control*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D018743:Perinatal Care / Q000379:methods
D018696:Neuroprotective Agents