Therapeutic Moderate Hypothermia for Severe Traumatic Brain Injury

摘要: Use of therapeutic hypothermia to treat patients with severe traumatic brain injury was described more than 50 years ago. Unexpected improvement in some these attributed hypothermia, but none the early studies systematically evaluated efficacy and many were thought have been harmed by treatment, particularly when cooled below 30°C or for longer 48 hours. Recent investigations found that moderate (32–34°C) relatively brief durations can improve histological behavioral outcome following experimental injury. Cooling this degree duration has not implicated as a cause cardiac arrhythmias, coagulation abnormalities, infections earlier studies. These laboratory also defined several neurochemical mechanisms through which may limit secondary swelling. Four clinical trials completed during past three years; each detected beneficial effect from cooling 32 34°C up In largest studies, shown significant neurological outcomes 3, 6, 12 months after those an initial Glasgow Coma Scale score 5 7. The associated hypothermia-induced reduction intracranial pressure cerebrospinal fluid levels interleukin-1β glutamate.