Targeted temperature management for ischemic stroke

Therapeutic hypothermia (TH) or targeted temperature management is an intentional cooling or temperature control technique using a thermostatic equipment (i.e., surface, endovascular, and focal devices) for specific therapeutic purposes. Given the modifiable determinants in the therapeutic process o...

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Main Author: Ji Man Hong
Format: Article
Language:English
Published: The Korean Neurocritical Care Society 2019-12-01
Series:Journal of Neurocritical Care
Subjects:
Online Access:http://www.e-jnc.org/upload/pdf/jnc-190100.pdf
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author Ji Man Hong
author_facet Ji Man Hong
author_sort Ji Man Hong
collection DOAJ
description Therapeutic hypothermia (TH) or targeted temperature management is an intentional cooling or temperature control technique using a thermostatic equipment (i.e., surface, endovascular, and focal devices) for specific therapeutic purposes. Given the modifiable determinants in the therapeutic process of acute ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage, several studies strongly reported that fever is closely associated with more harmful neurological outcomes. Fever or hyperthermia can deteriorate the cellular ischemic cascade, causing more cerebral damage owing to increased metabolic demands, enhanced release of excitatory neurotransmitters, and increased toxic free radical production. Despite the disappointing results of various clinical trials on TH in the stroke field, many studies have repeatedly clarified its fundamental mechanisms, which proved its strong neuroprotection in experimental stroke models. In particular, the potential effectiveness of TH can be revisited in the era of endovascular thrombectomy for patients undergoing emergent large-vessel occlusion because neuroprotection is maximized in ischemia-reperfusion injury models. This review aims to incorporate current literature into risks and benefits in patients with ischemic stroke.
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spelling doaj.art-50300f496ffe4ba5bbebe4026e1eb5f42022-12-22T00:54:14ZengThe Korean Neurocritical Care SocietyJournal of Neurocritical Care2005-03482508-13492019-12-01122677310.18700/jnc.190100315Targeted temperature management for ischemic strokeJi Man HongTherapeutic hypothermia (TH) or targeted temperature management is an intentional cooling or temperature control technique using a thermostatic equipment (i.e., surface, endovascular, and focal devices) for specific therapeutic purposes. Given the modifiable determinants in the therapeutic process of acute ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage, several studies strongly reported that fever is closely associated with more harmful neurological outcomes. Fever or hyperthermia can deteriorate the cellular ischemic cascade, causing more cerebral damage owing to increased metabolic demands, enhanced release of excitatory neurotransmitters, and increased toxic free radical production. Despite the disappointing results of various clinical trials on TH in the stroke field, many studies have repeatedly clarified its fundamental mechanisms, which proved its strong neuroprotection in experimental stroke models. In particular, the potential effectiveness of TH can be revisited in the era of endovascular thrombectomy for patients undergoing emergent large-vessel occlusion because neuroprotection is maximized in ischemia-reperfusion injury models. This review aims to incorporate current literature into risks and benefits in patients with ischemic stroke.http://www.e-jnc.org/upload/pdf/jnc-190100.pdfhypothermiahypothermia, inducedreperfusion injuryreperfusion
spellingShingle Ji Man Hong
Targeted temperature management for ischemic stroke
Journal of Neurocritical Care
hypothermia
hypothermia, induced
reperfusion injury
reperfusion
title Targeted temperature management for ischemic stroke
title_full Targeted temperature management for ischemic stroke
title_fullStr Targeted temperature management for ischemic stroke
title_full_unstemmed Targeted temperature management for ischemic stroke
title_short Targeted temperature management for ischemic stroke
title_sort targeted temperature management for ischemic stroke
topic hypothermia
hypothermia, induced
reperfusion injury
reperfusion
url http://www.e-jnc.org/upload/pdf/jnc-190100.pdf
work_keys_str_mv AT jimanhong targetedtemperaturemanagementforischemicstroke