Therapeutic hypothermia for head injury

作者：Phil Alderson, David F. Signorini, Chirag G. Patil · 发表于：Cochrane Database of Systematic Reviews · 年份：2004 · DOI：10.1002/14651858.cd001048.pub2 · 被引用次数：91 · 研究领域：Traumatic Brain Injury and Neurovascular Disturbances、Thermal Regulation in Medicine、Cardiac Arrest and Resuscitation

Background Induced hypothermia has been used in the treatment of head injury for many years. Encouraging results from small trials and laboratory studies led to renewed interest in the area and some larger trials. Objectives To estimate the effects of mild induced hypothermia in moderate and severe head injury on mortality, long‐term functional outcome, complications, and short‐term control of intracranial pressure (ICP). Search methods We searched the Injuries Group Specialised register, CENTRAL, MEDLINE and EMBASE. We handsearched conference proceedings and checked reference lists of relevant articles, including a systematic review published in 2003. Selection criteria Randomised controlled trials of mild hypothermia to 34 to 35ºC for at least 12 hours versus control (open or normothermia) in patients with any closed head injury requiring hospitalisation. Two authors independently assessed all trials. Data collection and analysis Data on death, Glasgow outcome scale, complications and ICP were sought and extracted, either from published material or by contacting the investigators. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each trial on an intention‐to‐treat basis. Quantitative synthesis of data on complications other than pneumonia or ICP was not attempted. Trials of immediate and deferred hypothermia were analysed separately. Main results We found 14 trials with 1094 participants. Active immediate hypothermia was associated with an OR for dea...