Therapeutic mild hypothermia has been widely used in brain injury. It has been evaluated in numerous clinical trials, and there is strong evidence for the use of hypothermia in treating patients with several types of ischemic/reperfusional (I/R) injuries, the examples being cardiac arrest and neonatal hypoxic-ischemic encephalopathy. In spite of many basic research projects demonstrating effectiveness, therapeutic hypothermia has not been proved effective for the heterogeneous group of patients with traumatic brain injury (TBI) in multicenter clinical trials. In the latest clinical trial, however, researchers were able to demonstrate the significant beneficial effects of hypothermia in one specific group; patients with mass evacuated lesions. This suggested that mild therapeutic hypothermia might be effective for I/R related TBI. In this article, we have reviewed much of the previous literature concerning the mechanisms of I/R injury to the protective effects of mild therapeutic hypothermia.
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