Meta-Analysis of Therapeutic Hypothermia for Traumatic Brain Injury in Adult and Pediatric Patients*

  title={Meta-Analysis of Therapeutic Hypothermia for Traumatic Brain Injury in Adult and Pediatric Patients*},
  author={Ellie Crompton and Irina Lubomirova and Ioana Cotlarciuc and Thang Sieu Han and Sapna Sharma and Pankaj Sharma},
  journal={Critical Care Medicine},
Objective: Therapeutic hypothermia has been used to attenuate the effects of traumatic brain injuries. However, the required degree of hypothermia, length of its use, and its timing are uncertain. We undertook a comprehensive meta-analysis to quantify benefits of hypothermia therapy for traumatic brain injuries in adults and children by analyzing mortality rates, neurologic outcomes, and adverse effects. Data Sources: Electronic databases PubMed, Google Scholar, Web of Science, Cochrane Central… 
The effectiveness of early prophylactic hypothermia in adult patients with traumatic brain injury: A systematic review and meta-analysis.
A meta-analysis of the effects of therapeutic hypothermia in adult patients with traumatic brain injury
It is demonstrated that therapeutic hypothermia did not reduce but might increase the mortality rate of patients with traumatic brain injury in some high-quality studies, but patients with elevated intracranial hypertension could benefit from hypotheria in therapeutic management instead of prophylaxis.
Revisited: A Systematic Review of Therapeutic Hypothermia for Adult Patients Following Traumatic Brain Injury
High-quality studies show no significant difference in mortality, poor outcomes, or new pneumonia, and a place for fever control in the management of traumatic brain injury.
Therapeutic Hypothermia in Critically Ill Patients: A Systematic Review and Meta-Analysis of High Quality Randomized Trials*
Routine application of therapeutic hypothermia would better be avoided outside the settings indicated by international guidelines (adult cardiac arrest and hypoxic-ischemic encephalopathy of newborns), as high-quality randomized evidence indicates.
Therapeutic hypothermia and targeted temperature management for traumatic brain injury: Experimental and clinical experience
Several factors that are important in enhancing the beneficial effects of therapeutic hypothermia in TBI are summarized and high-quality multicenter randomized controlled trials that incorporate these factors are required to maximize the benefits of this experimental therapy.
Therapeutic hypothermia to reduce intracranial pressure after traumatic brain injury: the Eurotherm3235 RCT.
In participants following TBI and with an ICP of > 20 mmHg, titrated therapeutic hypothermia successfully reduced ICP but led to a higher mortality rate and worse functional outcome, which favoured standard care alone.
Therapeutic hypothermia in children: Which indications remain in 2018?
  • F. Thabet, B. Tabarki
  • Medicine, Biology
    Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
  • 2019
Impact of Mild Hypothermia on Final Outcome of Patients with Acute Stroke: A Randomized Clinical Trial
The findings of this study indicate that Hypothermia has a significant statistical and clinical effect on the acute stroke outcome and it can be argued that hypothermia therapy can increase the level of consciousness and reduce the risk of death in stroke patients.
Statistical analysis plan for the POLAR-RCT: The Prophylactic hypOthermia trial to Lessen trAumatic bRain injury-Randomised Controlled Trial
A detailed and prospective analysis plan has been developed for the POLAR-RCT and specifies the statistical models for evaluation of primary and secondary outcomes, as well as defining covariates for adjusted analyses and methods for exploratory analyses.
Treatment options for severe traumatic brain injuries in children: current therapies, challenges, and future prospects
Several emerging therapies are addressed that focus on treating related secondary injuries and other clinical sequelae post-TBI during the acute injury phase (defined by authors as up to four weeks post-injury).


Hypothermia treatment for traumatic brain injury: a systematic review and meta-analysis.
An updated meta-analysis of the effects of hypothermia therapy on mortality, favorable neurologic outcome, and associated adverse effects in adults with traumatic brain injury (TBI) for use by BTF/AANS task force supports previous findings that hypothermic therapy constitutes a beneficial treatment of TBI in specific circumstances.
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.
Moderate hypothermia treatment in adult patients with severe traumatic brain injury: A meta-analysis
MHT may be effective in reducing death and unfavourable clinical neurological outcomes, but this finding is not statistically significant, except for decreasing the mortality in Asian patients.
Is therapeutic hypothermia beneficial for pediatric patients with traumatic brain injury? A meta-analysis
Hypothermia may slightly increase the risk of mortality in children with traumatic brain injury and the ratio of cardiac arrhythmia after this hypothermia therapy is slightly higher than that in normothermia groups.
Discrete cerebral hypothermia in the management of traumatic brain injury: a randomized controlled trial.
The cooling cap was not effective in establishing a statistically significant cranial-bladder temperature gradient or in reaching the target intracranial temperature in the majority of patients.
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.
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.
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.