Therapeutic hypothermia for out-of-hospital cardiac arrest: An update for neurosurgeons

Joji Inamasu, Masashi Nakatsukasa, Masaru Suzuki, Satoru Miyatake

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Background Neurosurgeons have been familiar with the idea that hypothermia is protective against various types of brain injuries, including traumatic brain injury (TBI). Recent randomized controlled trials, however, have failed to demonstrate the efficacy of therapeutic hypothermia (TH) in patients with TBI. On the other hand, TH becomes popular in the treatment of out-of-hospital cardiac arrest (OHCA) survivors, after randomized controlled trials have shown that survival rate and functional outcome is improved with the use of TH in selected patients. We believe that knowledge on the recent progress in TH for OHCA is useful for neurosurgeons, because feedback of information obtained in the treatment of OHCA may revitalize the interest in TH for neurosurgical disorders, particularly TBI. Methods A review of the literature was conducted with the use of PubMed. Results Various cooling techniques and devices have been developed and trialed in the treatment of OHCA survivors, including prehospital cooling with bolus ice-cold saline, endovascular cooling catheters, and new generation surface cooling devices, some of which have already been known to neurosurgeons. The efficacy of these new methods and devices has been demonstrated in many preliminary studies, and phase III trials are also expected. Conclusions Neurosurgeons and critical care medicine physicians pursue the same goal of rescuing the brain from the secondary injury despite the difference in etiology (focal trauma vs. global ischemia), with the presumption that earlier and faster implementation of TH will result in better outcome. Thoughtful application of knowledge and techniques obtained in OHCA to TBI under a rigorously controlled situation will make a small, but significant difference in the outcome of TBI victims.

Original languageEnglish
Pages (from-to)120-128
Number of pages9
JournalWorld neurosurgery
Volume74
Issue number1
DOIs
Publication statusPublished - 2010 Jul

Keywords

  • Out-of-hospital cardiac arrest
  • Prehospital cooling
  • Randomized controlled trial
  • Therapeutic hypothermia
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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