Therapeutic impact of hypothermia in traumatic brain injury management: systematic review

Abstract

Background: Traumatic brain injury(TBI) is an important component of mortality rate(MR) among young adults. Hypothermia(HT) is a treatment with questionable efficacy, given existing discordant views. Objective: investigate the performance of HT in TBI. Methods: Randomized controlled trials(RCT) from PUBMED, over the last five years, were analysed through the descriptors “Traumatic brain injury”; “Therapeutic hypothermia” and its MeSH variations. RCTs in individuals over 19 were included. After criteria were applied, four were selected for this review. This systematic review was submitted for registration on the PROSPERO plataform(ID: 253817). Results: Eurotherm3235 segregated n=387 to a group subjected to HP and another to standard treatment, evaluating them through the Glasgow Scale. The RCT was interrupted due potential damage to the participants, and showed greater MR(p <0.05) in the experimental group (EG). The POST-HOC of the B-HYPO sorted n=129 into a control group on fever management, and another group subjected to HT, separating them according to the injury. The patients with minor severity from the EG showed higher MR(p <0.05). The RCT from Chunhai T et al.(n=60) subjected to decompressive hemicraniectomy, which were divided into those who received HT, and a control group, displaying an inferior MR in the EG (p<0.05). Feng JZ et al. with n=14 subjected the EG to HT, and analysed the participants through the magnetic resonance metabolomics, showing lesser MR and better recovery in the EG(p<0.05). Conclusion: The studies indicated disparate results. However, those with larger samples indicated worse prognosis between patients subjected to HT.