Therapeutic hypothermia for stroke: Unique challenges at the bedside
Therapeutic hypothermia has shown promise as a means to improving neurological outcomes at several neurological conditions. At the clinical level, it has been shown to improve outcomes in comatose survivors of cardiac arrest and in neonatal hypoxic ischemic encephalopathy, but has yet to be convinci...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.951586/full |
| _version_ | 1811205106667880448 |
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| author | Je Sung You Jong Youl Kim Midori A. Yenari |
| author_facet | Je Sung You Jong Youl Kim Midori A. Yenari |
| author_sort | Je Sung You |
| collection | DOAJ |
| description | Therapeutic hypothermia has shown promise as a means to improving neurological outcomes at several neurological conditions. At the clinical level, it has been shown to improve outcomes in comatose survivors of cardiac arrest and in neonatal hypoxic ischemic encephalopathy, but has yet to be convincingly demonstrated in stroke. While numerous preclinical studies have shown benefit in stroke models, translating this to the clinical level has proven challenging. Major obstacles include cooling patients with typical stroke who are awake and breathing spontaneously but often have significant comorbidities. Solutions around these problems include selective brain cooling and cooling to lesser depths or avoiding hyperthermia. This review will cover the mechanisms of protection by therapeutic hypothermia, as well as recent progress made in selective brain cooling and the neuroprotective effects of only slightly lowering brain temperature. Therapeutic hypothermia for stroke has been shown to be feasible, but has yet to be definitively proven effective. There is clearly much work to be undertaken in this area. |
| first_indexed | 2024-04-12T03:24:58Z |
| format | Article |
| id | doaj.art-449c53f1a3cf4d6982233b99eca2339d |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T03:24:58Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-449c53f1a3cf4d6982233b99eca2339d2022-12-22T03:49:45ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-10-011310.3389/fneur.2022.951586951586Therapeutic hypothermia for stroke: Unique challenges at the bedsideJe Sung You0Jong Youl Kim1Midori A. Yenari2Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Anatomy, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Neurology, The San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United StatesTherapeutic hypothermia has shown promise as a means to improving neurological outcomes at several neurological conditions. At the clinical level, it has been shown to improve outcomes in comatose survivors of cardiac arrest and in neonatal hypoxic ischemic encephalopathy, but has yet to be convincingly demonstrated in stroke. While numerous preclinical studies have shown benefit in stroke models, translating this to the clinical level has proven challenging. Major obstacles include cooling patients with typical stroke who are awake and breathing spontaneously but often have significant comorbidities. Solutions around these problems include selective brain cooling and cooling to lesser depths or avoiding hyperthermia. This review will cover the mechanisms of protection by therapeutic hypothermia, as well as recent progress made in selective brain cooling and the neuroprotective effects of only slightly lowering brain temperature. Therapeutic hypothermia for stroke has been shown to be feasible, but has yet to be definitively proven effective. There is clearly much work to be undertaken in this area.https://www.frontiersin.org/articles/10.3389/fneur.2022.951586/fullischemic strokesystemic therapeutic hypothermiaselective brain coolingtargeted temperature managementcell deathinflammation |
| spellingShingle | Je Sung You Jong Youl Kim Midori A. Yenari Therapeutic hypothermia for stroke: Unique challenges at the bedside Frontiers in Neurology ischemic stroke systemic therapeutic hypothermia selective brain cooling targeted temperature management cell death inflammation |
| title | Therapeutic hypothermia for stroke: Unique challenges at the bedside |
| title_full | Therapeutic hypothermia for stroke: Unique challenges at the bedside |
| title_fullStr | Therapeutic hypothermia for stroke: Unique challenges at the bedside |
| title_full_unstemmed | Therapeutic hypothermia for stroke: Unique challenges at the bedside |
| title_short | Therapeutic hypothermia for stroke: Unique challenges at the bedside |
| title_sort | therapeutic hypothermia for stroke unique challenges at the bedside |
| topic | ischemic stroke systemic therapeutic hypothermia selective brain cooling targeted temperature management cell death inflammation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.951586/full |
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