Does Hypothermic Treatment Provide an Advantage After Spinal Cord Injury Until Surgery? An Experimental Study

Abstract

We compared the effects of early and late stage hypothermia treatment after spinal cord injury. Five groups each consisting of seven rats were included in this study. In Group 1a (Clip applied-non-treatment group) and Group 1b (Clip applied-treated group) the spinal cords were harvested 1 h after the injury. In Group 2a (clip applied, non-treated group) and Group 2b (clip applied-treated group) the injured segments were harvested 24 h after injury. Group 3 was designed as the sham-operated group. The significantly lower levels of TBARS and GSH-Px in Group 2a, as compared with Group 1b suggests that the hypothermia was effective in the early stage of treatment (P < 0.05). In contrast, TBARS and GSH-Px levels were significantly increased at the 24 h timepoint following treatment (P < 0.05). Short-term systemic hypothermia reduces lipid peroxidation in the early stages after spinal cord injury. This beneficial effect disappears 24 h following systemic hypothermic treatment.

Effects of Intrathecal Caffeic Acid Phenethyl Ester and Methylprednisolone on Oxidant/Antioxidant Status in Traumatic Spinal Cord Injuries

“…3 Increasing edema and inflammation, generation of oxygen radicals and lipid peroxidation, and dysfunction of adenosine diphosphate-dependent channels are important components of this vicious cycle. 1,2,4,[22][23][24] Lipid peroxidation can be defined as degradation of the lipids in the cell membrane after interaction with oxygen radicals. Free radicals initiate a chain reaction that breaks down the double bonds of unsaturated fatty acids in the presence of oxygen.…”

“…Traumatic spinal cord injury (SCI) is composed of primary spinal cord damage and of a series of secondary biochemical mechanisms leading to further damage. [1][2][3] Posttraumatic decomposition in the tissue perfusion increases the generation of oxygen radicals and gives way to lipid peroxidation. Lipid peroxidation is an important step in secondary spinal cord damage.…”

Therapeutic Hypothermia in Spinal Cord Injury: The Status of Its Use and Open Questions

“…In a dog thoracic spinal cord compression model, Wells and Hansebout [ 144 ] initiated local hypothermia (6 °C) at 4 h after compression injury and maintained it for 1, 4 or 18 h. The greatest degree of functional recovery was achieved in the 4 h duration group, rather than 1 or 18 h [ 145 ]. In experimental SCI studies using systemic hypothermia, the duration of hypothermia employed has been highly variable across published reports over the last decade ( Table 2 ), being from minutes through to 48 h [ 41 , 42 , 55 , 56 , 57 , 78 , 93 , 109 , 132 , 137 , 139 , 141 , 145 , 146 , 147 , 148 , 149 ]. Recently, Vipin and colleagues [ 150 ] utilized uninjured rats to study the potential adverse effects of prolonged, semi-invasive, local hypothermia (30 ± 0.5 °C, durations of 5 or 8 h).…”

“…In the field of SCI, however, there are no standards to follow in terms of the most optimal rewarming rate to employ after hypothermia administration. While some studies have used natural rewarming at room temperature or on a heating pad with no temperature records on timed recovery ( Table 1 , [ 78 , 109 , 145 ]), others have rewarmed the animals for a period of about 30 min ( Table 1 , [ 55 , 56 , 57 ]). There have also been reports of more standardized protocols involving rewarming animals at a rate of 1 °C/h [ 42 , 93 ] or 2 °C/h [ 41 ].…”

Akzidentelle Hypothermie beim Polytrauma

“…Darüber hinaus bewirkt eine Hypothermie eine Apoptose-Inhibierung durch Hemmung der Apoptose-Aktivierung sowie Regulation pro-und anti-apoptotischer Proteine (bax, bcl-2) und Mitogen-activated Protein-Kinasen [26]. Des Weiteren reduziert eine Hypothermie den oxidativen Stress durch eine verminderte Freisetzung und gleichzeitig gesteigerte, glutathionabhängige Reduktion von O 2 -Radikalen [27]. Insgesamt scheint, die Hypothermie einen protektiven Effekt gegenüber dem Auftreten von SIRS zu haben, dem jedoch die erhöhte Infektanfälligkeit infolge der anti-inflammatorischen, immunsuppressiven Wirkung entgegensteht [28].…”