Hypothermia therapy after traumatic brain injury in children.

@article{Hutchison2008HypothermiaTA,
  title={Hypothermia therapy after traumatic brain injury in children.},
  author={James S. Hutchison and Roxanne E. Ward and Jacques R. Lacroix and Paul Hebert and Marcia A. Barnes and Desmond J. Bohn and Peter B. Dirks and Steve Doucette and Dean A. Fergusson and Ronald Gottesman and Ari R. Joffe and Haresh M. Kirpalani and Philippe G Meyer and Kevin P Morris and David Moher and Ram N. Singh and Peter Skippen},
  journal={The New England journal of medicine},
  year={2008},
  volume={358 23},
  pages={
          2447-56
        },
  url={https://api.semanticscholar.org/CorpusID:46833}
}
In children with severe traumatic brain injury, hypothermia therapy that is initiated within 8 hours after injury and continued for 24 hours does not improve the neurologic outcome and may increase mortality.
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In conclusion, moderate hypothermia provided neuronal protection for children with severe TBI, and maintaining the intracranial temperature at 34.5 degrees C for 72 h was safe in this clinical setting.

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In patients with an intracranial pressure of more than 20 mm Hg after traumatic brain injury, therapeutic hypothermia plus standard care to reduce intrac Cranial pressure did not result in outcomes better than those with standard care alone.

Hypothermia After Traumatic Brain Injury.

Effect of Hypothermia Therapy on Children with Traumatic Brain Injury: A Meta-Analysis of Randomized Controlled Trials

The meta-analysis indicated that hypothermia therapy may increase the Glasgow Outcome Scale (GOS) scores, however, in terms of improving the rate of complications, intracranial pressure, mortality, cerebral perfusion pressure, and length of stay both in hospital as well as pediatric ICU, the difference was not statistically significant.

Induced Mild Hypothermia in Children after Brain Injury

Mild induced hypothermia can be safely used in pediatric patients after severe traumatic or posthypoxic brain injury and this method may be of benefit while improving outcomes in children.

Hypothermia for Traumatic Brain Injury in Children—A Phase II Randomized Controlled Trial*

Early therapeutic hypothermia in children with severe traumatic brain injury does not improve outcome and should not be used outside a clinical trial.

Hypothermia following pediatric traumatic brain injury.

It is expected that hypothermia initiated early after severe TBI will have a protective effect on the pediatric brain and can be done safely, but this still remains to be definitively tested.

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial

Among patients with severe traumatic brain injury, early prophylactic hypothermia compared with normothermic management did not improve neurologic outcomes at 6 months, and these findings do not support the use of early proPHylactic Hypothermia for patients withsevere traumatic brain injuries.

Hypothermia not Supported as a Therapeutic Option for Traumatic Brain Injury in Recent Randomized Trial.

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43 References

Lack of effect of induction of hypothermia after acute brain injury.

Treatment with hypothermia, with the body temperature reaching 33 degrees C within eight hours after injury, is not effective in improving outcomes in patients with severe brain injury.

Treatment of acute traumatic brain injury in children with moderate hypothermia improves intracranial hypertension

In children with acute traumatic brain injury, 48 hrs of moderate hypothermia, in conjunction with standard conventional management of intracranial hypertension and a favorable cerebral physiology compared with patients treated with normothermia is hypothesized to be safe and not associated with serious adverse clinical events, such as bleeding, electrolyte disturbances, pneumonia, or other infections.

Phase II Clinical Trial of Moderate Hypothermia after Severe Traumatic Brain Injury in Children

Moderate hypothermia after severe TBI in children was found to be safe relative to standard management and NORM in children of all ages and in children with delay of initiation of treatment up to 24 hours, and functional outcome tended to improve from the 3- to 6-month cognitive assessment in HYPO compared with NORM.

Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy.

Whole-body hypothermia reduces the risk of death or disability in infants with moderate or severe hypoxic-ischemic encephalopathy and causes no increase in major disability among survivors.

Hypothermia in the management of traumatic brain injury

Although meta-analysis suggests that iatrogenic hypothermia may confer a marginal benefit in neurological outcome, there does not appear to be clear evidence of lower mortality rates in unselected traumatic brain injury patients.

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest.

In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation, therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality.

Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia.

Treatment with moderate hypothermia appears to improve outcomes in patients with coma after resuscitation from out-of-hospital cardiac arrest, according to preliminary observations.

Treatment window for hypothermia in brain injury.

When hypothermia was administered immediately or 60 minutes after TBI, injured rats showed an improvement in functional outcome and a decrease in edema, and Delay of treatment by 90 or 120 minutes postinjury did not result in this neurological protection.

Treatment of Comatose Survivors of Out-of-hospital Cardiac Arrest With Induced Hypothermia

Treatment with moderate hypothermia appears to improve outcomes in patients with coma after resuscitation from out-of-hospital cardiac arrest, and is associated with a lower cardiac index, higher systemic vascular resistance, and hyperglycemia.

Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review.

Therapeutic hypothermia may reduce the risks of mortality and poor neurologic outcome in adults with TBI, but the evidence is not yet sufficient to recommend routine use of therapeutic Hypothermia for TBI outside of research settings.