Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Date of Graduation
TBI = Traumatic Brain Injury
Glasgow Outcome Scale = GOS
Glasgow Outcome Scale Extended = GOSE
Objective: To determine whether hypothermia induction improves long-term morbidity and mortality in patients with severe traumatic brain injury
Methods: A search was conducted using PubMed database and the search terms “induced hypothermia” and “traumatic brain injury”. Studies were excluded if the publication dates were over 10 years old, children were the population being studied, and the researchers were looking at other independent variables.
Results: The results from all three randomized control trials showed that the induction of hypothermia did not show effectiveness in the treatment of patients with a TBI compared to patients in the normothermia groups. However, one of the three studies did show better outcomes in patients with intracranial hematomas that underwent surgery and were also maintained at a hypothermic body temperature compared to a normothermic body temperature. This result deserves further research to determine whether this treatment could be applied to the general population of patients with intracranial hematomas.
Conclusion: At this time, it is not recommended to induce hypothermia in patients with a traumatic brain injury because it does not improve long-term morbidity and mortality but more research should be conducted to determine whether this treatment strategy could be of use in the future.
1. Traumatic brain injury - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557. Accessed November 17, 2019. 2. Rittenberger J, Callaway C. Uptodate. https://www.uptodate.com/contents/post-cardiac-arrest-management-in-adults?search=targeted%20temperature%20management&source=search_result&selectedTitle=1~98&usage_type=default&display_rank=1#H486105069. Accessed October 1, 2019. 3. Clifton GL, Valadka A, Zygun D, et al. Very early hypothermia induction in patients with severe brain injury (the National Acute Brain Injury Study: Hypothermia II): a randomised trial. Lancet Neurol. 2011;10(2):131–139. doi:10.1016/S1474-4422(10)70300-8 4. Peter JD Andrews, H Louise Sinclair, Aryelly Rodríguez, et al. Therapeutic hypothermia to reduce intracranial pressure after traumatic brain injury: the Eurotherm3235 RCT. Health Technology Assessment. 2018;(45). doi:10.3310/hta22450. 5. Cooper DJ, Nichol AD, Bailey M, et al. Effect of early sustained prophylactic hypothermia on neurologic outcomes among patients with severe traumatic brain injury: The POLAR randomized clinical trial. JAMA. 2018;320(21):2211-2220. https://doi.org/10.1001/jama.2018.17075. Accessed 10/31/2019. doi: 10.1001/jama.2018.17075. 6. Olsen A. Cognitive Control Function and Moderate-to-Severe Traumatic Brain Injury: Functional and Structural Brain Correlates. https://www.researchgate.net/figure/Glasgow-outcome-scale-GOS-and-Glasgow-outcome-scale-extended-GOSE_tbl2_272176279 Accessed November 17, 2019. 7. Holzer M. Targeted temperature management for comatose survivors of cardiac arrest. http://dx.doi.org/10.1056/NEJMct1002402. doi:10.1056/NEJMct1002402 8. Researcher: Mental health issues often progress after brain injury | The Spokesman-Review. https://www.spokesman.com/stories/2019/apr/03/researcher-mental-health-issues-often-progress-aft/. Accessed December 5, 2019.