Hypothermia in Spinal Cord Injury Clinical Protocols in Central Nervous System (CNS) Trauma
No clinical guidelines or protocols establishing efficacy for the use of therapeutic hypothermia after human spinal cord injury have been published in peer reviewed journals, though media attention surrounding its recent use may give the impression it should be a standard treatment.
Clinical Protocols in Cardiac Arrest
Therapeutic Hypothermia has been in clinical use for cardiac arrest since the Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR) made the following recommendations in October 2002:
● Unconscious adult patients with spontaneous circulation after out-of-hospital cardiac arrest should be cooled to 32°C to 34°C for 12 to 24 hours when the initial rhythm was ventricular fibrillation (VF).
● Such cooling may also be beneficial for other rhythms or in-hospital cardiac arrest.
Various medical institutions have agreed to share their Therapeutic Hypothermia protocols via http://www.med.upenn.edu/resuscitation/hypothermia/index.shtml
Research Protocols in CNS Trauma
The Department of Neurological Surgery/Miami Project at the University of Miami Miller School of Medicine/Jackson Memorial Medical Center is currently conducting research protocols approved by the UM institutional review board to evaluate the use of hypothermia in patients with acute brain or spinal cord injury and intraoperatively for neuroprotection. Moderate hypothermia (33 degrees Celsius/92 degrees Fahrenheit) is induced via a cooling catheter that is placed in a large blood vessel. Cooling is maintained for a 48 period followed by a slow re-warming of one degree every 8 hours. For more information about cooling catheters, see http://www.alsius.com/US/index.html
For a list of other clinical trials involving the use of Therapeutic Hypothermia, see http://www.clinicaltrials.gov/
For a list of scientific publications and manuscripts by University of Miami Miller School of Medicine and Miami Project investigators, see Hypothermia References. Additional references are cataloged at http://www.pubmed.com/
For an overview of therapeutic hypothermia, you may find the following articles helpful:
Couzin J (2007) Medicine. The big chill. Science 317:743-745 at http://www.sciencemag.org/cgi/content/full/317/5839/743
Guest J, Dietrich W: Therapeutic hypothermia following spinal cord trauma and ischemia. In Tisherman S, Stertz F (eds): Therapeutic Hypothermia (Molecular and Cellular Biology of Critical Care Medicine), ed First. New York: Springer, 2005, p 1010-119.
For information on the 2nd International Brain Hypothermia Symposium on October 24-27, 2007, Miami Beach, FL, see: http://cmetracker.net/UMIA/Files/Brochures/1715.pdf
This symposium is sponsored by the University of Miami Miller School of Medicine Division of Continuing Medical Education (http://www.med.miami.edu/med/education/cme/ ). |
