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Therapeutic hypothermia involves the controlled reduction of core temperature to attenuate the secondary organ damage which occurs following a primary injury. Clinicians have been increasingly using therapeutic hypothermia to prevent or ameliorate various types of neurological injury and more recently for some forms of cardiac injury. In addition, some recent evidence suggests that therapeutic hypothermia may also provide benefit following acute kidney injury. In this review we will examine the potential mechanisms of action and current clinical evidence surrounding the use of therapeutic hypothermia. We will discuss the ideal methodological attributes of future studies using hypothermia to optimise outcomes following organ injury, in particular neurological injury. We will assess the importance of target hypothermic temperature, time to achieve target temperature, duration of cooling, and re-warming rate on outcomes following neurological injury to gain insights into important factors which may also influence the success of hypothermia in other organ injuries, such as the heart and the kidney. Finally, we will examine the potential of therapeutic hypothermia as a future kidney protective therapy.

Original publication

DOI

10.1016/j.injury.2011.03.027

Type

Journal

Injury

Publication Date

09/2011

Volume

42

Pages

843 - 854

Addresses

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Elizabeth.moore@monash.edu

Keywords

Animals, Humans, Rats, Brain Injuries, Brain Ischemia, Hypoxia, Brain, Myocardial Ischemia, Reperfusion Injury, Water-Electrolyte Imbalance, Basal Metabolism, Body Temperature, Critical Care, Perinatal Care, Perioperative Care, Rewarming, Hypothermia, Induced, Time Factors, Adult, Clinical Trials as Topic, Meta-Analysis as Topic, Practice Guidelines as Topic, Acute Kidney Injury, Out-of-Hospital Cardiac Arrest