MacLellan Crystal L, Clark Darren L, Silasi Gergely, Colbourne Frederick
Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada.
J Neurotrauma. 2009 Mar;26(3):313-23. doi: 10.1089/neu.2008.0580.
Therapeutic (induced) hypothermia (TH) has been extensively studied as a means to reduce brain injury following global and focal cerebral ischemia, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Here, we briefly review the clinical and experimental evidence supporting the use of TH in each condition. We emphasize the importance of systematically evaluating treatment parameters, especially the duration of cooling, in each condition. We contend that TH provides considerable protection after global and focal cerebral ischemia, especially when cooling is prolonged (e.g., >24 h). However, there is presently insufficient evidence to support the clinical use of TH for ICH and SAH. In any case, further animal work is needed to develop optimized protocols for treating cardiac arrest (global ischemia), and to maximize the likelihood of successful clinical translation in focal cerebral ischemia.
治疗性（诱导性）低温（TH）已被广泛研究，作为一种减轻全脑和局灶性脑缺血、脑出血（ICH）及蛛网膜下腔出血（SAH）后脑损伤的方法。在此，我们简要回顾支持在每种情况下使用TH的临床和实验证据。我们强调在每种情况下系统评估治疗参数的重要性，尤其是降温持续时间。我们认为，全脑和局灶性脑缺血后TH能提供相当大的保护作用，特别是当降温时间延长时（例如，>24小时）。然而，目前尚无足够证据支持将TH用于ICH和SAH的临床治疗。无论如何，需要进一步开展动物实验，以制定治疗心脏骤停（全脑缺血）的优化方案，并最大程度提高局灶性脑缺血临床转化成功的可能性。
