AUTHOR=Drew Kelly L. , Bhowmick Saurav , Laughlin Bernard W. , Goropashnaya Anna V. , Tøien Øivind , Sugiura M. Hoshi , Wong Ardy , Pourrezaei Kambiz , Barati Zeinab , Chen Chao-Yin 

TITLE=Opportunities and barriers to translating the hibernation phenotype for neurocritical care

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1009718

DOI=10.3389/fneur.2023.1009718

ISSN=1664-2295

ABSTRACT=Targeted temperature management is still standard of care for out of hospital cardiac arrest and neonatal hypoxic ischemic encephalopathy (HIE). Despite challenges to demonstrate efficacy in large clinical trials individual cases and experience of some clinicians argue against abandonment of this intervention. Mammalian hibernation is a gold standard of neuroprotective metabolic suppression, that if better understood might simplify TTM and improve overall efficacy. To translate hibernation or torpor for neurocritical care the technology must accommodate human vulnerability for cerebral ischemia/reperfusion injury. By contrast with humans, hibernating species tolerate ischemia/reperfusion without injury. Such tolerance limits risk of transitions into and out of torpor. Here we summarize what is known about reanimation or arousal from hibernation and discuss what this teaches us about how to safely reverse synthetic torpor in humans.