Hypothermia for traumatic brain injury.

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• Hypothermia has a long history in brain injury treatment.
• Renewed interest emerged due to promising small trials and lab studies, prompting larger investigations.

Purpose of the Study:

• To evaluate the impact of mild hypothermia on mortality, long-term functional outcomes, and complications in traumatic brain injury (TBI).

Main Methods:

• Systematic review of randomized controlled trials (RCTs) comparing hypothermia (≤35°C for ≥12 hours) to normothermia (36.5-38°C) in hospitalized TBI patients.
• Searched multiple databases up to March 2016 and updated in June 2017.
• Assessed data on mortality, Glasgow Outcome Scale, and pneumonia; meta-analysis was not performed due to study heterogeneity and inconsistencies.

Main Results:

• Included 37 RCTs with 3110 participants; 33 reported mortality, 31 unfavorable outcomes, and 14 pneumonia.
• Inconsistent results across studies prevented meta-analysis.
• Studies were generally poorly reported, with low to very low GRADE quality evidence for outcomes.

Conclusions:

• No high-quality evidence supports hypothermia's benefit for TBI.
• Methodologically robust research is essential to establish hypothermia's true effect in TBI management.