Regional Cerebral Blood Flow and Glucose Utilization during Hypothermia in Newborn Dogs

Palmer, Charles; Vannucci, Robert C.; Christensen, Melanie A.; Brucklacher, Robert M.

doi:10.1097/00000542-198911000-00017

Cited by 49 publications

(16 citation statements)

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“…It is notable that post-cooling normothermia values for CMRO2 remained approximately 15% below baseline values. Similar to CMRO2, reductions in CMRglucose and CBF are found to be directly proportional to intrinsic flow and metabolic rate with the highest reductions in the normally most metabolically active areas [103] . While metabolic reductions may contribute to lower ICP, this is likely not the full explanation.…”

Section: Increased Intracerebral Pressurementioning

confidence: 72%

“…During cooling, CMRglucose and CBF are directly proportional to intrinsic flow and metabolic rate with reductions normally in the most metabolically active areas [103] . In the uninjured brain, animal data routinely demonstrates CBF and CMRO2 are closely coupled from 33 ℃-35 ℃, with reduction in CBF nearly parallels that of CMRO2 with an 8% decrease per ℃ [104] .…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

“…In the uninjured brain, CBF and cerebral metabolic rate are closely coupled from 33-35 ℃; with that coupling becoming inconsistent between 28-33 ℃ [67,93,103,[191][192][193][194] . The 2011 consensus review of TTM in critical care contends the uncertainty of the mechanism of action for ICP reduction in TTM precludes an affirmative recommendation.…”

Section: Increased Intracerebral Pressurementioning

confidence: 99%

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Use of hypothermia in the intensive care unit

Corry¹

2012

WJCCM

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Used for over 3600 years, hypothermia, or targeted temperature management (TTM), remains an ill defined medical therapy. Currently, the strongest evidence for TTM in adults are for out-of-hospital ventricular tachycardia/ventricular fibrillation cardiac arrest, intracerebral pressure control, and normothermia in the neurocritical care population. Even in these disease processes, a number of questions exist. Data on disease specific therapeutic markers, therapeutic depth and duration, and prognostication are limited. Despite ample experimental data, clinical evidence for stroke, refractory status epilepticus, hepatic encephalopathy, and intensive care unit is only at the safety and proof-of-concept stage. This review explores the deleterious nature of fever, the theoretical role of TTM in the critically ill, and summarizes the clinical evidence for TTM in adults.

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Section: Increased Intracerebral Pressurementioning

confidence: 72%

Section: Cerebral Blood Flowmentioning

confidence: 99%

Section: Increased Intracerebral Pressurementioning

confidence: 99%

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Use of hypothermia in the intensive care unit

Corry¹

2012

WJCCM

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“…Although the mechanism of neuroprotection in response to hypothermia remains unclear, hypothermia seems to alleviate brain damage through several mechanisms: prevention of blood-brain barrier disruption; reduction of cerebral glucose metabolism and oxygen consumption; reduction of the accumulation of excitotoxic neurotransmitters, intracellular acidosis, intracellular calcium influx, and oxygen-free radical production; alteration of the expression of cold shock proteins; reduction of brain edema; minimization of the risk of thrombosis; and decreasing the risk of epileptic activities. [26][27][28][29][30][31][32][33][34][35][36] Prior studies have shown that the mortality associated with this condition is high, even after the strongest medical treatments available. Additionally, although DC could improve the mortality, the neurological outcome of patients with MCHI remained unsatisfactory.…”

Section: Discussionmentioning

confidence: 99%

Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

Liu

Zhang

et al. 2016

Stroke

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Background and Purpose-We conducted this randomized controlled trial to investigate the effects of therapeutic hypothermia on mortality and neurological outcome in patients with massive cerebral hemispheric infarction. Methods-Patients within 48 hours of symptom onset were randomized to either a hypothermia group or a control group.Patients in the hypothermia group were given standard medical treatment plus endovascular hypothermia with a target temperature of 33 or 34°C. Hypothermia was maintained for a minimum of 24 hours. Patients in the control group were given standard medical treatment only with a target temperature of normothermia. The primary end points were mortality and the modified Rankin Scale score at 6 months. Results-There were 16 patients in the hypothermia group and 17 patients in the control group. At 6 months, 8 patients had died in the hypothermia group versus 7 patients in the control group (P=0.732). The main cause of death was fatal herniation caused by a pronounced rise in intracranial pressure. Seven patients (43.8%) had a modified Rankin Scale of 1 to 3 in the hypothermia group versus 4 patients (23.5%) in the control group (P=0.282). Additionally, of the survivors, patients in the hypothermia group achieved better neurological outcomes compared with those in the control group (7/8, 87.5% versus 4/10, 40.0%; P=0.066; odds ratio=10.5; 95% confidence interval, 0.9-121.4). Conclusions-Mild

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“…14 C]antipyrine method proved to be reliable during hypothermic conditions 11,28,29 and has even been used for the determination of CBF in hibernating squirrels with a core temperature of 9°C. 20 …”

Section: Applicability Of Autoradiographic Methods During Hypothermiamentioning

confidence: 99%

Mild and Moderate Hypothermia (α-Stat) Do Not Impair the Coupling Between Local Cerebral Blood Flow and Metabolism in Rats

Krafft

Frietsch

Lenz

et al. 2000

Stroke

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Background and Purpose-The effects of hypothermia on global cerebral blood flow (CBF) and glucose utilization (CGU) have been extensively studied, but less information exists on a local cerebral level. We investigated the effects of normothermic and hypothermic anesthesia on local CBF (LCBF) and local CGU (LCGU). Methods-Thirty-six rats were anesthetized with isoflurane (1 MAC) and artificially ventilated to maintain normal PaCO 2 (␣-stat). Pericranial temperature was maintained normothermic (37.5°C, nϭ12) or was reduced to 35°C (nϭ12) or 32°C (nϭ12 35°C rϭ0.96, 32°C rϭ0.96, PϽ0.05). The LCBF-to-LCGU ratio increased from 1.5 to 2.5 mL/mol during anesthesia (PϽ0.05), remained at 2.4 mL/mol during mild hypothermia, and decreased during moderate hypothermia (2.1 mL/mol, PϽ0.05). Conclusions-Anesthesia and hypothermia induce divergent changes in mean CBF and CGU. However, local analysis demonstrates a well-maintained linear relationship between LCBF and LCGU during normothermic and hypothermic anesthesia.

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Regional Cerebral Blood Flow and Glucose Utilization during Hypothermia in Newborn Dogs

Cited by 49 publications

References 0 publications

Use of hypothermia in the intensive care unit

Use of hypothermia in the intensive care unit

Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

Mild and Moderate Hypothermia (α-Stat) Do Not Impair the Coupling Between Local Cerebral Blood Flow and Metabolism in Rats

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