A multicenter randomized trial was stopped early because hypothermia worsened outcomes when used as second-line therapy for elevated intracranial pressure.
Induced hypothermia has become popular for treating cerebral edema from traumatic brain injury (TBI), but we do not know the effect on long-term outcomes. Therefore, European investigators performed a multicenter randomized trial of hypothermia for TBI. The authors recruited patients with TBI and intracranial pressure >20 mm Hg for ≥5 minutes despite first-line therapy with mechanical ventilation, sedation, analgesia, head-of-bed elevation, cerebrospinal fluid drainage, and surgical removal of space-occupying lesions. Participants were randomized to second-line therapy with mannitol with or without hypertonic saline (control group) or to induced hypothermia (32–35°C), with hyperosmotic therapy only if needed (hypothermia group). Third-line …
Reviewing Author
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)