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Therapeutic Hypothermia in Neurologic Diseases

  • Ankur Khandelwal
Chapter

Abstract

Therapeutic hypothermia (TH) or targeted temperature management (TTM) is one of the most encouraging tools that has conferred neuroprotection in cardiac arrest and ischemic encephalopathy. Further, it has been investigated in a variety of acute neurological disorders comprising intracranial hypertension, traumatic brain injury, intracerebral hemorrhage, acute ischemic stroke, status epilepticus, central nervous system infections, and spinal cord injury. Various favorable properties of TH such as reduction of intracranial pressure, antiepileptic effect, preservation of blood brain barrier integrity, scavenging of free radicals, and reducing reperfusion injury continue to generate tremendous interest in the field of clinical neuroscience. Majority of the experimental studies have shown neurological improvement with the application of TH in various neurological conditions. However, clinical trials have failed to demonstrate consistent benefit in reducing mortality and morbidity. Moreover, a wide range of side effects and lack of specialized critical care units have prevented its widespread applicability. Further, there are no formal guidelines regarding the appropriate timing of initiation of TH, rapidity, optimal depth, and duration of cooling along with specific patient populations that may benefit. Larger randomized controlled trials is the need of the hour to demonstrate a consistent favorable neurological outcome following application of TH.

Keywords

Cardiac arrest Cerebral hemorrhage Encephalopathy Intracranial pressure Neuroprotection Reperfusion injury Status epilepticus Shivering Therapeutic hypothermia 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Ankur Khandelwal
    • 1
  1. 1.Department of Neuroanaesthesiology and Critical CareAll India Institute of Medical SciencesNew DelhiIndia

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