Mechanisms of therapeutic hypothermia effect on brain damage in hypoxiaand ischemia
Ischemia and hypoxia are major factors of brain damage. Cerebral injury takes time to develop, with acute, subacute, and chronic phases specified. Reparative processes run simultaneously with damage cascades. Every phase of cerebral injury is characterized with specific pathophysiological cascades. Induced hypothermia has been implemented in neurocritical care for several decades, and its efficacy has been proved in patients after cardiac arrest and in newborns with perinatal hypoxic-ischemic encephalopathy. However, in other neurocritical care settings the efficacy of has not been demonstrated yet. On the other hand, the results of experimental studies and discovered mechanisms of hypothermia effects on pathophysiological cascades of cerebral injury and repair give hope for the hypothermia to become a valuable option for the neurocritical care. In the presented review hypothermia effects on numerous pathophysiological cascades of cerebral injury due to hypoxia and ischemia are described.