Cold as a therapeutic agent

Abstract

The use of cold as a therapeutic agent has a long and colorful history. The Edwin Smith Papyrus, the most ancient medical text known, dated 3500 B.C., made numerous references to the use of cold as therapy. Baron de Larrey, a French army surgeon during Napoleon's Russian campaign, packed the limbs in ice prior to amputations to render the procedures painless. In the early twentieth century, a neurosurgeon, Temple Fay, pioneered "human refrigeration" as a treatment for malignancies and head injuries. In 1961, Irving Cooper developed the first closed cryoprobe system and ushered in the modern era of cryogenic surgery with his imperturbable convictions. Fay's early work fell victim to the disruptive sequel of the World War II. The Nazis confiscated his data (presented before the Third International Cancer Congress in 1939) forwarded to Belgium for publication and brutally applied his refrigeration techniques experimentally without any benefit of anesthesia in the concentration camps, especially Dachau. Hypothermia became associated in the public mind with the atrocities exposed at the war trials in Nürnberg. After lying dormant for decades, the interest was rekindled in the late 80s when mild hypothermia was shown to confer dramatic neuroprotection in a number of experimental models of brain injury. With several large multi-center clinical studies currently under way, hypothermia is receiving unprecedented attention from the medical and scientific communities.

Regional cooling for reducing brain temperature and intracranial pressure

“…The clinical application of cerebral hypothermia began with the pioneering work of neurosurgeon Temple Fay, in 1938, but the program was abandoned during the second world war 12 . From the 1950s, studies on profound cerebral hypothermia beginning.…”

Hypothermic Cooling Measured by Thermal Magnetic Resonance Imaging; Feasibility and Implications for Virtual Imaging in the Urogenital Pelvis

“…28–33°C) support neuroprotective safety in humans, during cardiac, kidney, and brain surgery. 8–14 Morales et al had demonstrated a direct reduction in neutrophils compared to non-cooled controls in RP histology supporting the reduction of inflammation hypothesis. 15 …”

Therapeutic hypothermia and targeted temperature management in traumatic brain injury: Clinical challenges for successful translation

“…Preclinical investigations have utilized a variety of clinically relevant TBI models in different species and genders to model brain injury and clarify primary and secondary injury processes that may be targeted by therapeutic interventions (Atkins et al, 2007; Atkins et al, 2010; Bregy et al, 2012; Chatzipanteli et al, 1999; Chatzipanteli et al, 2000; Rosomoff and Holaday, 1954; Wang et al, 2006). Based on preclinical work, it is known that TBI leads to a spectrum of secondary injury mechanisms including ionic fluctuations, excitotoxicity, necrosis and apoptotic cell death and inflammation.…”