Hypothermia Therapy After Traumatic Brain Injury: A Systematic Review and Meta-Analysis

The purpose of this article was mainly to focus on whether hypothermia improves mortality and/or the chance of a good neurological outcome compared with the standard of care alone in patients with traumatic brain injury (TBI). We used a comprehensive search strategy. Articles were eliminated in a stepwise fashion. Data from each study was entered in the Review Manager (RevMan) software version 5.0 when reported. Seven studies including 1331 patients met all selection criteria. This meta-analysis merged all data of the 7 articles to come to a conclusion. It also conducted a detailed analysis of the different classifications, trying to outline the possible mechanisms. We included two Chinese articles and tried to find out the effects of hypothermia on the Asian race. Regarding the poor outcome of hypothermia on diffuse lesions, we also analyzed the mechanism and provided our speculation. Children with traumatic brain injury were also analyzed regarding the effect of hypothermia treatment and the possible cause of the poor outcome. The results of these clinical trials were heterogeneous. Hypothermia treatment in TBI seems to provide good outcomes on focal lesions, adult patients, Asian patients and at a relatively higher temperature (33-36°C).