Applying cerebral hypothermia and brain oxygen monitoring in treating severe traumatic brain injury: a preliminary study.

摘要

or the last decade, vertebral hypothermia has been widely used to treat patients with hypoxic brain damage after cardiac arrest resulting from ventricular tachycardia or ventricular fibrillation. Use of hyperthermia in the treatment of patients in the acute stage of severe traumatic brain injury (TBI) is still very controversial. Clifton et al. (1) showed a negativeeffect of hypothermia on outcome of patients with severe TBI. In contrast, Polderman (2) proved the effectiveness of hypothermia in treatment of intracranial hypertension (ICH) in patients with severe TBI.According to modern evidence-based guidelines, the evident significance of six randomized controlled trials of moderate quality does not show that hypothermia is closely associated with a statistically significant mortality decrease. Patients with a Glasgow Coma Scale score of 4-5 may benefit, however, from using hyperthermia within 48 hours in the acute period of TBI. Interpretation of results is complicated by small study groups and great variability of temperature reactions at admission. That is why recommendations for the management of severe TBI by using hyperthermia are class III evidence-based recommendations.