新生児・小児医学

抽象的な

Acute Neuralgia in Infants can be managed with Cerebral Hypothermia and Temperature Control

Misav Mira

In the adult intensive care unit, brain hypothermia (BHT) has been reported to be effective in neuroprotection after resuscitation and cardiac arrest. In contrast, in the neonatal intensive care unit, the pathophysiology of brain injury from hypoxic-ischemic encephalopathy (HIE) has been attributed to ischemia/reperfusion-induced circulatory impairment using neonatal brain cryotherapy. The International Liaison Committee on Resuscitation, 2010, recommends brain cryotherapy for HIE associated with severe neonatal pseudoparenchymal death. The utility of BHT for neuroprotection in infants and children, especially childhood acute encephalopathy, is expected. In theory, BHT could be useful in basic medical research and animal experiments. However, clinical plans for the treatment of pediatric acute encephalopathy have limitations. No international studies have been conducted and there is no clinical evidence of neuroprotection using BHT. This review describes the pathogenesis of neuronal injury in hypoxic and hypoperfused brains. History of BHT, its effects and mechanism of action. Methods of Cooling and Monitoring BHT; Side Effects of BHT. Review recent literature on target temperature management used to maintain and control body temperature in adults in the ICU. Finally, we discuss the development of BHT and targeted temperature management as a treatment for pediatric acute encephalopathy.