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Therapeutic hypothermia in traumatology
S A Tisherman1, A Rodriguez, P Safar
1Safar Center for Resuscitation Research, University of Pittsburgh, Pennsylvania, USA. tishermansa@msx.upmc.edu
The Surgical Clinics of North America
|January 8, 2000
Summary
Therapeutic hypothermia shows promise for brain and organ protection after cardiac arrest, traumatic brain injury, and hemorrhagic shock. Further research is needed to optimize controlled hypothermia protocols for trauma patients.
Area of Science:
- Medical research
- Physiology
- Trauma care
Background:
- Hypothermia has a history of fluctuating clinical interest for organ protection.
- Renewed interest since the 1980s focuses on therapeutic hypothermia for brain resuscitation and extracerebral organ preservation, especially during hemorrhagic shock (HS).
Purpose of the Study:
- To evaluate the current evidence for therapeutic hypothermia in various clinical scenarios.
- To highlight the need for further research into the benefits and challenges of controlled hypothermia.
- To advocate for prospective trials of controlled hypothermia in trauma patients.
Main Methods:
- Review of existing laboratory and clinical studies on hypothermia.
- Analysis of data from animal and human studies concerning cardiac arrest, traumatic brain injury (TBI), and hemorrhagic shock (HS).
Main Results:
- Mild-to-moderate hypothermia demonstrates benefits in animals and humans post-cardiac arrest, TBI, and during/after HS.
- Uncontrolled versus controlled hypothermia implications in trauma and methods to prevent shivering remain unclear.
- Significant data support the potential of hypothermia in trauma resuscitation.
Conclusions:
- Controlled hypothermia holds significant potential for improving outcomes in trauma patients, including reducing mortality and organ failure.
- Prospective trials are warranted to establish optimal protocols for therapeutic, controlled hypothermia in traumatic HS and resuscitation.
- Future applications may include suspended animation for delayed resuscitation in severe trauma.