Cooling of children with severe traumatic brain injury.

摘要

In this issue of The Lancet Neurology, P David Adelson and colleagues report findings from their multicentre, randomised controlled trial of therapeutic hypothermia versus normothermia in 77 children with severe traumatic brain injury.1 All patients were treated according to management guidelines with intracranial pressure monitoring.2 The interventions were complex; patients randomly allocated to therapeutic hypothermia were cooled, using cold (4°Q intravenous saline followed by surface cooling, to a target temperature of 32-33°C for 48-72 h. If a patient's intracranial pressure was greater than 20 mm Hg at 48 h, the patient was cooled for an additional 24 h. Rewarming was done slowly over several days. Patients randomly allocated to normothermia were maintained between 36-5°C and 37-5°C