The effect of hypothermia in combination therapies for cerebral ischaemia: A review of animal trials

Due to the complex nature of the injury in cerebral ischaemia, it is expected that treatment with multiple agents with a variety of actions will be of greatest benefit. Hypothermia is of considerable clinical interest as it is neuroprotective on its own and is easily combined with other therapies. This review considers laboratory studies in which hypothermia is evaluated with and without a second therapy for cerebral ischaemia. In these studies, hypothermia makes a variety of contributions to the outcomes. Hypothermia is frequently synergistic with other therapies, sometimes plays a permissive role, often is of equivalent or greater efficacy than the combination and in a few cases is entirely responsible for neuroprotective effect. Thus, hypothermia makes an excellent candidate for inclusion in combination therapies, but needs to be assessed individually in each case.