Hypothermia Doesn't Cut Intracranial Pressure in TBI
Therapeutic hypothermia plus standard care doesn't improve outcome over standard care alone
WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- For patients with traumatic brain injury, therapeutic hypothermia plus standard care does not improve outcome over standard care alone, according to a study published online Oct. 7 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 3 to 7 in Berlin.
Peter J.D. Andrews, M.D., M.B., Ch.B., from the University of Edinburgh in the United Kingdom, and colleagues examined the effect of hypothermia on functional outcome in patients with traumatic brain injury. Adults with an intracranial pressure of more than 20 mm Hg despite stage 1 treatments were randomized to standard care or hypothermia plus standard care.
Owing to safety concerns, the study was suspended in October 2014 after enrollment of 387 patients. The researchers found that 54 and 44 percent of patients in the control and hypothermia groups required stage 3 treatments to control intracranial pressure. For the Extended Glasgow Outcome Scale, the adjusted common odds ratio was 1.53 (P = 0.04), suggesting worse outcome in the hypothermia group. A favorable outcome occurred in 26 and 37 percent of the hypothermia and control groups, respectively (P = 0.03).
"Therapeutic hypothermia plus standard care to reduce intracranial pressure did not result in outcomes better than those with standard care alone," the authors write.