Interventions to reduce body temperature to 35 ⁰C to 37 ⁰C in adults and children with traumatic brain injury

Lewis, Sharon R; Baker, Philip; Andrews, Peter; Cheng, Andrew; Deol, Kiran; Hammond, Naomi; Saxena, Manoj

doi:10.1002/14651858.cd006811.pub4

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…Moreover, a meta-analysis of a single RCT involving 41 participants found no evidence supporting the reduction of body temperature to between 35°C and 37.5°C in people with TBI with a long-term outcome. Serious adverse effects were associated with poor outcomes 60 (1b). Another meta-analysis of 23 trials that involved a total of 2796 patients investigated therapeutic hypothermia versus normothermia management in patients with TBI, and it was found that mortality rates were more significant in the therapeutic hypothermia group (RR=1.26, 95% CI: 1.04–1.53).…”

Section: Discussionmentioning

confidence: 99%

Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review

Gedeno,

Neme,

Jemal

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: In underdeveloped countries, there is a greater incidence of mortality and morbidity arising from trauma, with traumatic brain injury accounting for 50% of all trauma-related deaths. The occurrence of elevated intracranial pressure, which is a common pathophysiological phenomenon in cases of traumatic brain injury, acts as a contributing factor to unfavorable outcomes. The aim of this systematic review is to analyze the existing literature regarding the management of adult traumatic brain injury with raised intracranial pressure in an intensive critical care unit, despite limited resources. Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Search engines such as PubMed, Cochrane database, and Google Scholar were utilized to locate high-level evidence that would facilitate the formation of sound conclusions. Result: A total of 11,715 articles were identified and individually assessed to determine their eligibility for inclusion or exclusion based on predetermined criteria and outcome variables. The methodological quality of each study was evaluated using recommended criteria. Ultimately, the review consisted of 51 articles. Conclusion: Physical examination results and noninvasive assessments of the Optic Nerve Sheath Diameter (ONSD) via sonography are positively associated with elevated intracranial pressure, and are employed as diagnostic and monitoring tools for elevated intracranial pressure in resource-limited settings. Management of elevated intracranial pressure necessitates an algorithmic approach that utilizes prophylactic measures and acute intervention treatments to mitigate the risk of secondary brain injury.

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Section: Discussionmentioning

confidence: 99%

Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review

Gedeno,

Neme,

Jemal

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Secondary brain injury, leading to damaged self-regulation, systemic hypotension, and brain ischemia as well as encephalic hypertension, is the main element affecting the prognosis of TBI patients [ 27 ]. The purpose of drug treatment is to minimize the secondary damage [ 31 , 32 ]. The cool therapy known as hyperthermia has the potential to treat the multiple pathological effects of central nervous system injuries [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Hypothermia Therapy on Children with Traumatic Brain Injury: A Meta-Analysis of Randomized Controlled Trials

Liu

Chen

et al. 2022

Brain Sciences

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Hypothermia therapy is a promising therapeutic strategy for traumatic brain injury (TBI); however, some trials have shown that hypothermia therapy has a negative effect on patients with TBI. The treatment of hypothermia in children with TBI remains controversial. We conducted a search of six online databases to validate the literature on comparing hypothermia with normal therapy for children with TBI. Eight randomized controlled trials (514 patients) were included. The meta-analysis indicated that hypothermia therapy may increase the Glasgow Outcome Scale (GOS) scores. However, in terms of improving the rate of complications, intracranial pressure (ICP), mortality, cerebral perfusion pressure (CPP), and length of stay both in hospital as well as pediatric ICU, the difference was not statistically significant. Hypothermia therapy may have clinical advantages in improving the GOS scores in children with TBI compared with normothermic therapy, but hypothermia therapy may have no benefit in improving the incidence of complications, ICP, mortality, CPP, and length of stay both in pediatric ICU as well as hospital. The decision to implement hypothermia therapy for children with TBI depends on the advantages and disadvantages from many aspects and these must be considered comprehensively.

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“…TTM encompasses different approaches; in this review, we will focus on controlled normothermia and treatment of fever, whereas therapeutic hypothermia will not be considered [4,[13][14][15][16][17][18][19]20]. In the absence of well conducted studies on the potential benefits of fever control in acute brain injured patients [21,22], we have reviewed the available literature and proposed an individualized approach for fever management in this setting.…”

Section: Introductionmentioning

confidence: 99%

Fever management in acute brain injury

Bogossian

Taccone

2022

Current Opinion in Critical Care

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Purpose of reviewFever is common after acute brain injury and is associated with poor prognosis in this setting. Recent findingsAchieving normothermia is feasible in patients with ischemic or hemorrhagic stroke, subarachnoid hemorrhage and traumatic brain injury. Pharmacological strategies (i.e. paracetamol or nonsteroidal antiinflammatory drugs) are frequently ineffective and physical (i.e. cooling devices) therapies are often required. There are no good quality data supporting any benefit from therapeutic strategies aiming at normothermia in all brain injured patients when compared with standard of care, where mild-to-moderate fever is tolerated. However, recent guidelines recommended fever control in this setting.

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Interventions to reduce body temperature to 35 ⁰C to 37 ⁰C in adults and children with traumatic brain injury

Abstract: Interventions to reduce body temperature to 35 C to 37 C in adults and children with traumatic brain injury.

Cited by 3 publications

References 35 publications

Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review

Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review

Effect of Hypothermia Therapy on Children with Traumatic Brain Injury: A Meta-Analysis of Randomized Controlled Trials

Fever management in acute brain injury

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