Hypothermia for Acute Brain Damage: Pathomechanism and Practical Aspects

352 Pages·2004·7.7 MB·English

by  Hubert L. Rosomoff (auth.)

N.Hayashi, R. Bullock, D.W. Dietrich,
T. Maekawa,A. Tamura(Eds.)
Hypothermia forAcuteBrain Damage
Pathomechanismand PracticalAspects
N. Hayashi, R. Bullock,
D.W. Dietrich, T. Maekawa,
A. Tamura (Eds.)
Hypothermia for
Acute Brain Damage
Pathomechanism and Practical Aspects
With 136Figures
~
Springer
Nariyuki Hayashi, M.D.
Professor, Department of Scientific Medicine, Nihon University
30 Oyaguchikamimachi, Itabashi-ku, Tokyo 173-8610, Japan
M. Ross Bullock, M.D.
Professor, Neurosurgery and Neurointensive Care Unit
Medical College of Virginia
Hospital of Virginia Commonwealth University
P.O. Box 980631, Richmond, VA, USA
Dalton W. Dietrich, Ph.D.
Distinguished Chair in Neurosurgery, Kinetic Concepts
Professor
Department of Neurological Surgery, Neurology and Cell Biology and Anatomy
University of Miami School of Medicine
Scientific Director, The Miami Project to Cure Paralysis
Miami, FL, USA
Tsuyoshi Maekawa, M.D.
Professor, Department of Emergency and Critical Care Medicine
Yamaguchi University School of Medicine
1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
Akira Tamura, M.D., Ph.D.
Professor, Department of Neurosurgery
Teikyo University School of Medicine
2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
Library of Congress Control Number: 2004109139
ISBN 978-4-431-67967-7 ISBN 978-4-431-53961-2 (eBook)
DOI 10.1007/978-4-431-53961-2
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Originally published by Springer-Verlag Tokyo in 2004
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Preface
TheInternational BrainHypothermiaSymposium2004wasthesecond time Ihavehad the
honorofopening such agatheringonbrainhypothermiatreatment.Itwasagreatpleasure
togreettheparticipantsinthehopethattheir valuablecontributionswouldmaketheTokyo
meeting memorable.
Brainhypothermiahaslongbeenseenasapromising methodthat mayovercomecurrent
limitations onbrain resuscitation inpatients with severebrain damage.However,although
excellentresultshavebeen obtainedinexperimentalanimal models,forsome reason brain
hypothermiahas not alwaysbeen successfulclinically,and resolvingthis problem hasbeen
amajorchallengefacingphysiciansspecializinginbraintherapies.TheICUmanagementof
recentresearchhasuncoverednewmechanisms ofbraindamagenotseeninanimalmodels,
including brain thermo-pooling at temperatures above 40°C in severe brain damage,
masking neuronal hypoxia even with normal cerebral blood flow. Stress-related hyper
glycemiawith brain hypothermiawasexpected to generate useful results in patients with
external injuries, cerebral occlusivestroke,and cardiac arrest. In recent clinical studies of
brainhypothermiatreatment,many excellentresultsbegan being reported on the manage
ment of severe brain injury, ischemic stroke, and post-resuscitation after cardiac arrest.
However,in clinicalbrain hypothermia treatment many questions remained about appro
priate treatment targets, leu management technique,prevention of complications,control
ofbrain tissue temperature,management ofhypothermiainsult,and mechanisms underly
ingthe onset ofvegetativestates.
Thesymposiumcameatan opportunetime to explorethis recent clinicalresearch and I
believethat allparticipantsbenefited from the many excellentpresentations and academic
discussions onawiderange oftopics.Theseincluded the development ofbasicresearch on
hypothermia,newfindingsonbrain-injurymechanisms,advancedtechniques forcontrol of
brain tissue temperature, control of the negative effectsof hypothermia, new findings in
management methods for persistent vegetation, and proposals for new concepts of brain
hypothermiatreatment.Igreatlyenjoyedthe manyacademic papers and the excellentfinal
plenarydiscussion byinvited speakers and allparticipants.
Forthisbook,averycarefulselectionofpaperswasmadebytheprogramcommittee,and
I hope that the increased understanding and knowledge of brain hypothermia treatment
brought about by the symposium and this volume of proceedings will contribute to
improved careforasmany patients aspossible.
Nariyuki Hayashi
Tokyo,April19,2004
v
Contents
Preface V
1. Opening the Doorto Hypothermia
Historical Reviewofthe Development of Brain Hypothermia
H.L.ROSOMOFF 3
2. Up-to-date Basic Science ofHypothermia
AReviewofthe Protective Effectsof Hypothermiaon theAxonaland Vascular
PathobiologyAssociated with TraumaticBrain Injury
J.T.POVLISHOCK,Y.UEDA,and E.P.WEI ................................. 19
Factors Regulating Hypothermic Protection in Experimental Modelsof
Brain Injury
W.D. DIETRICH,T.SUZUKI,and H.M.BRAMLETT 24
EffectsofBrain Hypothermiaon Brain Edema FormationAfter Intracerebral
Hemorrhagein Rats
N.KAWAI,M.KAWANISHI,M.OKAUCHI,and S.NAGAO 29
Hypothermia Prolongs Survival Time ofSeverelySeptic Rats:AStudy Usinga
Computer-SupportedMultichannelThermoregulatorySystem
S.YAMASHITA,F.COLBOURNE,M.FUJITA,T.INOUE,N.MATSUYAMA,
Y.ODA,H.YAMASHITA,S.KASAOKA,K.OKABAYASHI,D.SADAMITSU,
and T.MAEKAWA ................. 36
Influence of Hypothermiaon NeuroprotectiveEffectofInhibiting
Neurotransmittersand Agonists ofTheir Receptors
V.1. KULINSKY,L.N.MINAKINA,T.V.GAVRILINA,5.5.GAVRILOV,
T.N.MEDVEDEVA,and G.V.MIKHELSON ................................. 41
3. Development ofBrain HypothermiaTreatment
ANewConcept ofBrain HypothermiaTreatmentand Pitfallsin Intensive Care
UnitHypothermiaManagement
N.HAYASHI 49
VII
VIII Contents
leu
4. Technique and Management ofBrain Hypothermia
IsHypothermia BeneficialbyPreventing Fever?
D.W.MARION ................ ..................................... . 79
Management ofInduced Hypothermiainthe IntensiveCareUnit
E.M.R.DOPPENBERG and R.BULLOCK 84
MicrodialysisforTimeCourseofExtracellular Glutamatein Poor-Grade
Aneurysm Patients:Preliminary Study
T.MORIYA,A.SAKURAI,A.UTAGAWA,K.KINOSHITA,and N.HAYASHI 90
MildBrainHypothermiaSuppressesOxygenFreeRadicalsin Patientswith
Neuroemergency:AnExVivoElectron SpinResonanceStudy
Y.MIHARA,K.DOHl,K.SATOH,H.MORIWAKI,T.KUROKI,Y.MIYAKE,
S.SHIODA,and T.ARUGA ............................................. 94
MathematicalAnalysisofExtremity Immersion CoolingforBrainTemperature
Management
X.Xu,W.SANTEE,1. BERGLUND,and R.GONZALEZ 98
RapidInductionofBrainHypothermiabySelectiveIntra-ArterialPerfusion of
Crystalloid Solutionin anAnimalModel
M.FURUSE,Y.KINOSHITA,N.ISONO,K.NISHIHARA,T.KUROIWA,
M.C.PREUL,and T.OHTA 102
CombinationofForcedAirCooling,CoolingbyCirculatingWaterMattress,and
IntravenousBolusInfusion ofIcedSalineIsan Effectiveand SafeTechniquefor
InductionofMildHypothermia During CerebralAneurysm Surgery
A.M.ZEITLINand A.Y.LOUBNINE 106
AutomaticAir-CoolingIncubating SystemforBrainHypothermiaTreatment
H.WAKAMATSUand 1. GAOHUA ....................................... 109
AutomaticTemperature Management Systemin Patientswith MildHypothermia:
Three CaseReports
Y.SHIMIZU,N.SAKURAI,Y.HOSHIYA,T.SASAKI,M.AGATA,
M.MATSUZUKI,K.KINOSHITA,and N.HAYASHI 116
IntraoperativeMildHypothermiain Neurosurgery
T.EGUCHI,T.HARA,R.KANAZAWA,Y.SAKATA,A.YAMASHITA,
T.KIN,and M.TAKAHASHI 122
TheImportance ofNursing Management inthe Treatment ofBrainHypothermia
H.NISHIO,Y.YAMAMOTO,M.MATSUZUKI,K.KINOSHITA,and N.HAYASHI 129
5. Hypothermia Response
Moderate HypothermiaAttenuatesthe Endothelium-DependentPialArteriole
Dilatation but Notthe Endothelium-IndependentResponsein Rats
I.YUZAWA,M.YAMADA,R.TANAKA,and K.FUJII 135
PialMicrocirculation EvaluatedbyClosedCranialWindowMethod 7DaysAfter
Impact AccelerationInjury inRats:DoesPost-TraumaticHypothermia Provide
Persisting PialVascularProtection?
Y.UEDA,E.P.WEI,and J.T.POVLISHOCK ................................. 141
Contents IX
6. Neonate and Pediatric BrainHypothermia
Hypothermia FollowingTraumatic BrainInjuryin Children
P.D.ADELSON. ..................................................... 147
ClinicalStudyofBrainMagnetic Resonance Imagesin Infants with Brain
Hypothermia
M.SHIMIZU,H.KIMOTO,and T.OHNO .................................. 158
Studyon BodyTemperature MonitoringDuring BrainHypothermiain Newborn
Infants with SevereHypoxic-Ischemic Encephalopathy
K.KOBAYASHI,S.IBARA,H.MARUYAMA,E.KATO,and Y.MARUYAMA 164
Neuropsychological Recoveryin Pediatric Patients with AcuteSubdural
Hematoma Treatedwith MildHypothermiaTherapy: Report ofTwoCases
S.YOKOBORI,H.TOMITA,O.TONE,M.TAMAKI,Y.SATO,M.NAKABAYASHI,
S.INADA,A.KATSUMI,S.SUZAKI,T.YAMAZAKI,H.YOKOTA,
and Y.YAMAMOTO. ................................................. 168
AdjunctiveTherapyApplication ofHyperbaric OxygenTherapyinChildren
AlreadyTreatedwith MildHypothermiaforDisturbance ofConsciousness
H.DOHGOMORI,K.ARIKAWA,H.IWAYA,R.MATSUBAYASHI,
I. KUKITA,and Y.KANMURA 174
7. Experimental Research and Clinical Management
a. Cerebral Stroke and Hypoxia
The Management ofCerebral StrokebyBrainHypothermiaTreatment
T.STEINER 181
TheNordic CoolingStrokeStudy-NOCSS.AMulticenter StudyofInduced Mild
Hypothermia inAcuteStrokePatients. OngoingClinicalTrial
D.}.WEBER and T.S.OLSEN ........................................... 186
Hypothermia in the Therapy ofIschemic Stroke
S.SCHWAB 190
CorrelationofHypothermiawith DecreaseofGlutathione Concentrationand
TolerancetoCerebral Ischemia
L.S.KOLESNICHENKO,V.I.KULINSKY,G.V.SOTNIKOVA,and V.Y. KOVTUN 195
HypothermiaProlongs the ViabilityofIschemic BrainTissueDueto
NeuroprotectionLinkedto Redistribution ofOxygenin Brain:Positron Emission
Tomography Studyofthe Critical First6hAfterStrokein Pigs
M.SAKOH,T.HORI,and A.GJEDDE 200
Neuroprotective EffectsofSelectiveBrainHypothermia (SBH)on Permanent
FocalCerebral Ischemia in Rats
T.TANIGUCHI,E.MORIKAWA,T.MORI,and T.MATsuI. .................... 204
The EffectsofMildand Deep Hypothermiaon the Neuronal Activityand Energy
Metabolism in BrainSlicesInVitro
Y.OKADA 208
X Contents
Ultra-EarlyInductionofBrainHypothermiafor Patientswith Poor-Grade
SubarachnoidHemorrhage
H.KOBATA,A.SUGIE,1.NISHIHARA,H.FUKUMOTO,and H.MORITA. ......... 215
BrainTemperature inPatientswith Chronic HydrocephalusAfterSubarachnoid
Hemorrhage
Y.HIRASHIMA,M.TAKABA,K.YAMASHITA,K.NOGAMI,R.MASUDA,
Y.MINO,and S.ENDO 220
TheInfluenceofMildHypothermiaon the IncidenceofVasospasmsin Patients
AfterSevereSubarachnoidHemorrhage
M.SMRCKA,V.JURAN,R.JURA,R.GAL,and V.SMRCKA .... ................ 225
EvaluationofResultsofTranscranial DopplerUltrasonographyin Postoperative
BrainHypothermiaTherapy forSevereCasesofSubarachnoid Hemorrhage
K.IKAKuRA,Y.NAoE,A.KITAHASHI,K.ONODERA,M.NAKABAYASHI,A.FUSE,
H.SATOH,H.YOKOTA,A.KUROKAWA,and Y.YAMAMOTO ................... 229
BodyTemperature inStroke:Secondary StressPhenomenonor Causal
Relationship?
T.S.OLSEN,U.J.WEBER,and L.P.KAMMERSGAARD ........................ 234
b. Head Injury
ImportantRegionalDifferencesin BrainTissueSusceptibilitytoSecondary
DamageAfterTraumatic BrainInjury
U.UNGERSTEDT .................................................... 238
ARandomized Controlled TrialofTherapeuticHypothermiainSevere
Head-Injured PatientsinJapan:Overviewofthe Protocol
T.MAEKAWA,N.HAYASHI,K.OGINO,J.TAKEZAWA,S.NAGAO,
Y.OHASHI,S.YAMASHITA,and K.OKABAYASHI ........................... 246
TheUseofMildHypothermiain the Prevention ofSecondary BrainInjury
M.SMRCKA,M.VIDLA.K,K.MACA,V.SMRCKA,and R.GAL.................. 251
HypothermiaMayAttenuateNotOnlyInterleukin-6 but alsoMatrix
Metalloproteinase-9 ofSystemicand InternalJugularBloodfrom the
InflammatoryResponsetoTraumatic BrainInjuryin Humans
E.SUEHIRO,H.FUJISAWA,T.AKIMURA,H.ISHIHARA,S.YAMASHITA,
T.MAEKAWA,and M.SUZUKI 255
Immune-EnhancingEffectofArginineon PatientswithSevereTraumatic Brain
Injuries WhoHaveUndergone TherapeuticBrainHypothermia
A.UTAGAWA,A.SAKURAI,K.KINOSHITA,T.MORIYA,and N.HAYASHI 259
Management ofPatientswith Traumatic BrainInjury: HypothermiaTherapy and
the ImportanceofTemperature Management
H.FUJISAWA,E.SUEHIRO,H.YONEDA,T.AKIMURA,
S.YAMASHITA,T.MAEKAWA,and M.SUZUKI ............................. 263
EvaluationofCerebraland SystemicFlow/MetabolismDuring BrainHypothermia
Therapy
Y.KURODA,K.NITTA,M.OTA,J.OHTO,Y.FUKUTA,T.OKAHISA,
T.ABE,and S.OSHITA 267
Contents XI
c. Cardiac Arrest
NovelPotentialsforEmergencyHypothermia:SuspendedAnimation with Delayed
Resuscitationfrom ExsanguinationCardiacArrest
P.M.KOCHANEK,S.A.TISHERMAN,S.W.STEZOSKI,
A.NOZARI,X.Wu,and P.SAFAR 271
ResuscitativeHypothermiain ComatoseSurvivorsAfterProlonged
CardiopulmonaryResuscitation and B-typeNatriureticPeptide fortheAdvanced
Challenge
K.NAGAO,N.HAYASHI,K.KANMATSUSE,K.KIKUSHIMA,
K.WATANABE,and T.MUKOUYAMA 278
SurvivalAfterSubarachnoidHemorrhage UsingBrainHypothermiaAfterRecovery
ofSpontaneous Circulation from CardiopulmonaryArrest:ACaseReport
K.KUWAMOTO,H.YOKOTA,H.SATO,N.SHIGA,S.YOKOBORI,Y.TAKAYAMA,
andY.YAMAMOTO 287
Indication ofBrainHypothermicTherapy in CardiacArrest
K.MORI,Y.TAKEYAMA,H.KANO,and Y.ASAI ................. ........... 297
BrainHypothermicTherapyFollowingCardiopulmonaryBypassforCardiac
Arrest PatientsWhoDidNotRespondtoAdvancedCardiovascular LifeSupport
Y.TAKEYAMA,K.MORI,H.KANO,S.NARA,Y.ITOH,M.HASE,and Y.ASAI ..... 302
AdvancedChallengein ResuscitativeHypothermiain Patientswith CardiacArrest
onArrivalatthe EmergencyRoom
K.NAGAO,E.NITOBE,K.OKAMOTO,T.MIKI,and N.HAYASHI. .............. 308
InfluenceofBrainHypothermiaon BloodInterleukin-6 Levels on Postresuscitated
PatientsAfterCardiacArrest
R.ABE,H.HIRASAWA,and S.ODA 315
ChangesofBloodGlutamate Levelsin HypoxicIschemicEncephalopathy Patients
Undergoing BrainHypothermia
K.KUMAZAWA,S.IBARA,K.KOBAYASHI,T.TOKUHISA,H.MARUYAMA,
Y.MAEDE,R.SHIMONO,E.KATO,and Y.MARUYAMA 320
8. Preventing PersistentVegetation
PersistentVegetationMeansUnconsciousness?HowtoManageVegetation
and Memory Disturbances FollowingSevereBrainDamage
N.HAYASHI,T.MORIYA,K.KINOSHITA,A.UTAGAWA,and A.SAKURAI 327
SignificanceofMusico-KineticTherapy for Patientswith Traumatic BrainInjury
FollowingTherapeutic Hypothermia
Y.SATO,Y.KOBAYASHI,A.YOSHIDA,M.MATSUZUKI,
T.MORIYA,T.EBIHARA,R.NODA,and N.HAYASHI. ....................... 343
SubjectIndex 347
1. Opening the Door to Hypothermia