Review
Version 1
Preserved in Portico This version is not peer-reviewed
Therapeutic Hypothermia for Severe Traumatic Brain Injury: an Overviews of Reviews and Future Prospects
Version 1
: Received: 16 April 2024 / Approved: 17 April 2024 / Online: 17 April 2024 (14:32:27 CEST)
How to cite: Kobata, H. Therapeutic Hypothermia for Severe Traumatic Brain Injury: an Overviews of Reviews and Future Prospects. Preprints 2024, 2024041171. https://doi.org/10.20944/preprints202404.1171.v1 Kobata, H. Therapeutic Hypothermia for Severe Traumatic Brain Injury: an Overviews of Reviews and Future Prospects. Preprints 2024, 2024041171. https://doi.org/10.20944/preprints202404.1171.v1
Abstract
Fever control is essential in patients with severe traumatic brain injury (TBI). The efficacy of therapeutic hypothermia (TH) in severe TBI has been investigated over the last few decades; however, in contrast to experimental studies showing benefits, no evidence of efficacy has been demonstrated in clinical practice. In this review, the mechanisms and history of hypothermia were briefly outlined, while the results of major randomized controlled trials (RCTs) and meta-analyses investigating TH for adult TBI are introduced and discussed. The retrieved meta-analyses showed conflicting results, with a limited number of studies indicating benefits of TH. Some studies have shown benefits of long-term TH compared with short-term TH. Although TH is effective at lowering elevated intracranial pressure (ICP), reduced ICP does not lead to favorable outcomes. Low-quality RCTs overestimated the benefits of TH, while high-quality RCTs showed no difference or worse outcomes with TH. RCTs assessing standardized TH quality demonstrated the benefits of TH. As TBI has heterogeneous and complicated pathologies, applying a uniform treatment may not be ideal. A meta-analysis of young patients who underwent early cooling and hematoma removal showed better TH results. TH should not be abandoned, and its optimal should be advocated on an individual basis.
Keywords
clinical trials; evacuated hematoma; meta-analysis; therapeutic hypothermia; traumatic brain in-jury
Subject
Medicine and Pharmacology, Neuroscience and Neurology
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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