Therapeutic hypothermia is a promising treatment for traumatic brain injury
More than 50 million people experience a traumatic brain injury (TBI) each year, and many experience physical, cognitive, and neurological impairments for months or years after injury. Given the serious public health risks associated with these injuries, researchers are working to develop innovative approaches to improve quality of life for individuals who have experienced TBI.
Recently, they have discovered that therapeutic hypothermia, a procedure in which health care providers lower the body’s temperature for a short time, may reduce the negative health impact associated with TBI. Evidence suggests that therapeutic hypothermia can protect the brain in the hours following TBI, but the technique remains controversial among health care providers who are concerned that the negative effects of body cooling may outweigh the potential benefits.
To address this controversy, a research team reviewed existing literature on therapeutic hypothermia to determine if the procedure is safe and effective for treating TBI. They identified 23 eligible, high-quality studies (including a total of 2,796 adult patients) that had examined therapeutic hypothermia as a TBI treatment. The researchers analyzed the outcomes of each study, finding that:
- Therapeutic hypothermia was associated with reduced mortality when it was initiated within 24 hours of TBI. However, therapeutic hypothermia administered after 24 hours was associated with higher mortality.
- Therapeutic hypothermia was more effective in reducing mortality when combined with standard hospital procedures for post-craniectomy care. Craniectomy is a surgical procedure that relieves pressure and swelling in the brain that may occur after TBI.
- Patients who received therapeutic hypothermia showed better functional outcomes (including cognitive, physical, and neurological functioning) than those who did not receive the therapy.
These findings suggest that therapeutic hypothermia is most effective when initiated 24 hours after TBI and when combined with routine post-surgery care measures. Individuals who receive therapeutic hypothermia within this time frame are more likely to survive their injuries and are less likely to experience the negative outcomes associated with TBI. Further research is necessary to refine and improve therapeutic hypothermia as a first-line treatment for TBI.
Chen H, Wu F, Yang P, et al. A meta-analysis of the effects of therapeutic hypothermia in adult patients with traumatic brain injury. Critical Care. (December 2019).