Hypothermia for neuroprotection after cardiac arrest: Mechanisms, clinical trials and patient care

Froehler, Michael T.; Geocadin, Romergryko G.

doi:10.1016/j.jns.2007.04.042

Cited by 78 publications

(39 citation statements)

References 70 publications

(82 reference statements)

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“…The thus termed "therapeutic hypothermia" provides neuroprotection for patients after a cardiac arrest, stroke, or spinal cord or head injuries (Cheung et al, 2006;Jiang and Yang, 2007;den Hertog et al, 2009) through several mechanisms that include reduction in brain metabolic rate, effects on cerebral blood flow, reduction of the critical threshold for oxygen delivery, blockade of excitotoxic mechanisms, calcium antagonism, preservation of protein synthesis, reduction of brain thermopooling, a decrease in edema formation, modulation of the inflammatory response, neuroprotection of the white and gray matter, and modulation of apoptotic cell death (Froehler and Geocadin, 2007). The acute management of these patients is a major challenge and determines the long-term clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Paracetamol-Induced Hypothermia Is Independent of Cannabinoids and Transient Receptor Potential Vanilloid-1 and Is Not Mediated by AM404

Ayoub

Pryce²,

Seed³

et al. 2011

Drug Metab Dispos

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ABSTRACT:In recent years, there has been increasing interest in hypothermia induced by paracetamol for therapeutic purposes, which, in some instances, has been reported as a side effect. Understanding the mechanism by which paracetamol induces hypothermia is therefore an important question. In this study, we investigated whether the novel metabolite of paracetamol, N-(4-hydroxyphenyl)arachidonylamide (AM404), which activates the cannabinoid (CB) and transient receptor potential vanilloid-1 (TRPV1) systems, mediates the paracetamolinduced hypothermia. The hypothermic response to 300 mg/kg paracetamol in CB 1 receptor (CB 1 R) and TRPV1 knockout mice was compared to wild-type mice. Hypothermia induced by paracetamol was also investigated in animals pretreated with the CB 1 R or TRPV1 antagonist 1-(2,4-dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-1-piperdinyl-1H-pyrazole-3-carboxamide trifluoroacetate salt (AM251) or 4-chloro-3-methoxycinnamanilide (SB366791), respectively. In CB 1 R or TRPV1 knockout mice, paracetamol induced hypothermia to the same extent as in wild-type mice. In addition, in C57BL/6 mice pretreated with AM251 or SB366791, paracetamol induced hypothermia to the same extent as in control mice. AM404 failed to induce hypothermia at pharmacological doses. Inhibition of fatty acid amide hydrolase (FAAH), which is involved in the metabolism of paracetamol to AM404, did not prevent the development of hypothermia with paracetamol. Paracetamol also induced hypothermia in FAAH knockout mice to the same extent as wild-type mice. We conclude that paracetamol induces hypothermia independent of cannabinoids and TRPV1 and that AM404 does not mediate this response. In addition, potential therapeutic value of combinational drug-induced hypothermia is supported by experimental evidence.

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Section: Discussionmentioning

confidence: 99%

Paracetamol-Induced Hypothermia Is Independent of Cannabinoids and Transient Receptor Potential Vanilloid-1 and Is Not Mediated by AM404

Ayoub

Pryce²,

Seed³

et al. 2011

Drug Metab Dispos

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show abstract

“…Animal and human data indicate that mild hypothermia is a standardized treatment for comatose survivors of cardiac arrest as it is neuroprotective and improves outcome after a period of global cerebral hypoxia-ischemia [38,39]. There are multiple mechanisms by which mild hypothermia may improve neurological outcome.…”

Section: Targeted Temperature Managementmentioning

confidence: 99%

Post-cardiac arrest brain injury: Pathophysiology and treatment

Chalkias

Xanthos

2012

Journal of the Neurological Sciences

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“…Se reconoce el menor nivel de evidencia para su empleo tras PC por ritmos no desfibrilables. En las recomendaciones, se revisan detenidamente: -Las bases fisiológicas que explican por qué la hipotermia moderada ha mostrado ser neuroprotectora y mejorar el pronóstico tras un periodo de hipoxiaisquemia cerebral global 61 .…”

Section: Infusiones IVunclassified

Novedades en soporte vital avanzado

et al. 2011

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Recibido el 6 de marzo de 2011; aceptado el 11 de marzo de 2011 PALABRAS CLAVEParada cardiaca; Resucitación; Soporte vital avanzado; Posresucitación; Pronóstico; Donación de órganos Resumen Se presentan a continuación algunas de las novedades más importantes en soporte vital avanzado que incorporan las nuevas recomendaciones internacionales en resucitación de 2010. Se destacan los aspectos relacionados con la prevención y detección precoz de la parada cardiaca intrahospitalaria, la resucitación en el hospital, el nuevo algoritmo de soporte vital avanzado, las técnicas y dispositivos de resucitación cardiopulmonar, los cuidados posresucitación, la valoración del pronóstico de los pacientes que sobreviven inicialmente a la parada y aspectos específicos relativos a la donación de órganos a corazón parado y la creación de centros de referencia de parada cardiaca. © 2011 Elsevier España, S.L. y SEMICYUC. Todos los derechos reservados. KEYWORDS Novelties in advanced life supportSummary We present some of the most important developments in advanced life support incorporating the new international recommendations for resuscitation 2010. The study highlights aspects related to prevention and early detection of in-hospital cardiac arrest, resuscitation in the hospital, the new advanced life support algorithm, the techniques and devices for cardiopulmonary resuscitation, post-resuscitation care, assessment of the prognosis of patients who survive initially, and specific aspects of non-beating heart organ donation and the creation of cardiac arrest referral centers.

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Hypothermia for neuroprotection after cardiac arrest: Mechanisms, clinical trials and patient care

Cited by 78 publications

References 70 publications

Paracetamol-Induced Hypothermia Is Independent of Cannabinoids and Transient Receptor Potential Vanilloid-1 and Is Not Mediated by AM404

Paracetamol-Induced Hypothermia Is Independent of Cannabinoids and Transient Receptor Potential Vanilloid-1 and Is Not Mediated by AM404

Post-cardiac arrest brain injury: Pathophysiology and treatment

Novedades en soporte vital avanzado

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