Brain Hypothermia Therapy and Targeted Temperature Management for Acute Encephalopathy in Children: Status and Prospects

• Published in: Journal of clinical medicine Vol. 12; no. 6; p. 2095
• Main Authors: Imataka, George, Fujita, Yuji, Kikuchi, Jin, Wake, Koji, Ono, Kazuyuki, Yoshihara, Shigemi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2023; MDPI
• Subjects: Body temperature; Brain damage; brain hypothermia therapy; Care and treatment; Clinical medicine; Clinical trials; Coma; Convulsions & seizures; Coronaviruses; COVID-19; Cytotoxicity; Development and progression; Edema; Encephalitis; Encephalopathy; hibernation; Hypothermia; Hypothermia, Induced; Hypoxia; Metabolism; Methods; Multisystem inflammatory syndrome in children; neuronal protection; Pediatric intensive care; Pediatric research; Pediatrics; Physiological aspects; Respiratory diseases; Review; target temperature management; Traumatic brain injury; Viral infections; Japan; neuronal protection; brain hypothermia therapy; hibernation; target temperature management
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12062095

In adult intensive care, brain hypothermia therapy (BHT) was reported to be effective in neuroprotection after resuscitation and cardiac arrest. By contrast, in neonatal intensive care, the pathophysiology of brain damage caused by hypoxic-ischemic encephalopathy (HIE) is attributed to circulatory disturbances resulting from ischemia/reperfusion, for which neonatal brain cryotherapy is used. The , 2010, recommends cerebral cryotherapy for HIE associated with severe neonatal pseudoparenchyma death. The usefulness of BHT for neuroprotection in infants and children, especially in pediatric acute encephalopathy, is expected. Theoretically, BHT could be useful in basic medical science and animal experiments. However, there are limitations in clinical planning for treating pediatric acute encephalopathy. No international collaborative study has been conducted, and no clinical evidence exists for neuroprotection using BHT. In this review, we will discuss the pathogenesis of neuronal damage in hypoxic and hypoperfused brains; the history of BHT, its effects, and mechanisms of action; the success of BHT; cooling and monitoring methods of BHT; adverse reactions to BHT; literature on BHT. We will review the latest literature on targeted temperature management, which is used for maintaining and controlling body temperature in adults in intensive care. Finally, we will discuss the development of BHT and targeted temperature management as treatments for pediatric acute encephalopathy.