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Monday 30 June 2014

Revisiting therapeutic hypothermia for severe traumatic brain injury...again

Revisiting therapeutic hypothermia for severe traumatic brain injury...again. Critical Care 2014, 18: 160

Marion, D.W. and Regasa, L.E.

http://ccforum.com/content/18/3/160

Improved understanding of the molecular mechanisms of secondary brain injury has informed the optimum depth and duration of cooling and led to increased clinical interest in the therapeutic moderate hypothermia for severe traumatic brain injury over the past two decades. Although several large multi-center clinical trials have not found a treatment effect, multiple single-center trials have, and a recent meta-analysis by Crossley and colleagues now finds that the cumulative findings of those single-center trials dilute the multi-center trial results and show an overall reduction in mortality and poor outcomes associated with cooling. The need for consistent support of key physiologic parameters during cooling is emphasized by this finding.

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