Hypothermia for Acute Spinal Cord Injury-A Review

OBJECTIVE: Spinal cord injury (SCI) is a catastrophic neurological event with no proven treatments that protect against its consequences. Potential benefits of hypothermia in preventing/limiting central nervous system injury are now well known. There has been an interest in its potential use after SCI. This article reviews the current experimental and clinical evidence on the use of therapeutic hypothermia in patients with SCI. METHODS: Review of literature. RESULTS: There are various mechanisms by which hypothermia is known to protect the central nervous system. Modest hypothermia (32 degrees C-34 degrees C) can deliver the potential benefits of hypothermia without incurring the complications associated with deep hypothermia. Several recent experimental studies have repeatedly shown that the use of hypothermia provides the benefit of neuroprotection after SCI. Although older clinical studies were often focused on local cooling strategies and demonstrated mixed results, more recent data from systemic hypothermia use demonstrate its safety and its benefits. Endovascular cooling is a safe and reliable method of inducing hypothermia. CONCLUSIONS: There is robust experimental and some clinical evidence that hypothermia is beneficial in acute SCI. Larger, multicenter trials should be initiated to further study the usefulness of systemic hypothermia in SCI.