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Report

The one day conference was held at UCLA Medical Center. This consisted of two sessions: The morning session was a roundtable discussion of the pertinent research issues involving neuroprotection and the use of therapeutic hypothermia (TH). Dr. Vespa outlined the clinical questions surrounding how TH may fit into the clinical treatment of patients with cardiac arrest, traumatic brain injury and stroke. Dr. Dietrich, an international expert in TH, outlined the animal studies that demonstrate the effectiveness of TH in neuroprotection. His talk discussed the molecular pathways that are effected by TH, showed evidence of anatomic and functional neuroprotection by TH, and created a scientific background to discuss how TH could be enhanced or improved by the use of concomitant neuroprotective drugs. Dr. Buckberg, a cardiothoracic surgeon and animal experimenter, outlined his cardiac-cerebral resuscitation paradigm using novel approaches and reviewed how TH intersects with his resuscitation strategy. Dr. Chmayssani, a fellow in Neurocritical Care, presented novel research on the use of TH to a mild degree, namely 36 C, to prevent neurochemical deterioration in humans, as monitored through cerebral microdialysis. The panel then discussed many key points and concluded the following summary findings: 1) The optimal timing and duration of TH remains uncertain. 2) The depth of temperature, 36 C vs 33C remains unclear, especially in light of new clinical trial results. 3) Resuscitation strategies need to part of TH. 4) Expansion of TH to other diseases such as spinal cord injury appears to be reasonable. 5) Prehopsital TH and speed of induction of TH needs to be studied. 6) Novel devices and strategies are needed to enable widespread use of TH in populations and clinical conditions that are not amenable to the current devices.

The afternoon session was a lecture series attended by 85 people in the UCLA main hospital auditorium. The discussions outlined the basic clinical approaches to TH in status epilepticus, cardiac arrest, brain trauma, spinal cord trauma, and stroke. The lectures were well received and many questions were discussed in an open forum.