Therapeutische Hypothermie in der neurologischen Intensivmedizin

Zusammenfassung

Therapeutische Hypothermie (TH) ist im Tierexperiment außerordentlich neuroprotektiv. Klinisch stellt TH die einzig wirksame neuroprotektive Maßnahme dar. In randomisierten Studien zum Herz-Kreislauf-Stillstand zeigten sich eine Verbesserung der funktionellen Outcomes sowie eine deutlich Verminderung der Letalität. Klinische Untersuchungen zu Schädel-Hirntrauma sind bisher inkonklusiv. Andere wichtige Indikationen wie TH beim ischämischen Schlaganfall sind noch nicht ausreichend klinisch untersucht. In aktuellen Phase II Studien wird TH zurzeit insbesondere in der Frühphase des Schlaganfalls unter Lysebedingungen untersucht. Die vorliegende Arbeit beschreibt die aktuelle Datenlage zur TH sowie offene Fragen für die Zukunft.

Abstract

Therapeutic hypothermia (TH) is very effective for the treatment of acute experimental brain injury. In contrast to other neuroprotective methods or pharmacological agents, TH represents the only clinically proven neuroprotective therapy. TH led to a decreased mortality rate and improved functional outcome in patients with cardiac arrest. Investigations in severe head trauma are inconclusive up to now. Other important indications such as ischemic stroke remain to be investigated properly. Recent phase II studies are on the way to test safety and feasibility in the early time window of stroke including thrombolysis. The recent article describes the status and perspectives including open questions for hypothermia in neurological intensive care.

Schlüsselwörter

Hypothermie - neurologische Intensivmedizin - Schlaganfall

Keywords

hypothermia - neurological critical care - stroke

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