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《Acta Universitatis Medicinalis Secondae Shanghai》 2005-03
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Multicenter Prospective Randomized Controlled Study of Efficacy of Mild Hypothermia for Severe Traumatic Brain Injured Patients with Intracranial Hypertension

JIANG Ji-yao, FANG Nai-cheng, ZHANG Jian-ping, LI Wei-ping, XU Wei, ZHU Cheng, XU Wen-hui, BAO Ying-hui, WANG Yong, QIU Yong-ming, LUO Qi-zhong (Department of Neurosurgery, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China ; Department f Neurosurgery, People's Hospital in Zhuji; Department of Neurosurgery, People's Hospital in Yixing; Department of Neurosurgery, The Second People's Hospital in Shenzheng; Department of Nerosurgery, The Second Teaching Hospital, Kunming Medical College; Shanghai Neurosurgical Institute)  
Objective To compare the effect of mild hypothermia versus normathermia on the outcome of 428 severe traumatic brain injured patients with severe cerebral contusion and intracranial hypertension ( GCS≤ 8 ). Methods At 6 medical centers, 428 patients with an admission Glasgow Coma Scale score of 8 or less were randomly divided into two groups: mild hypothermia 32 ℃-35 ℃ group (n =210) ,and normathermia (37 ±0.5)℃ group (n = 218). Results According to the glasgow outcome scale at 6 months follow-up, 75 cases got good recovery (35. 7% ) , 32 had moderate deficit (15. 2% ) , 50 severe deficits (23. 8% ) , 7 persistent vegetative status (3.3% ) and 46 were dead (21.9% ) in mild hypothermia group. However, only 56 cases got good recovery (25.7% ) , 25 had moderate deficit (11.5% ) , 58 severe deficits (26.6% ) , 8 persistent vegetative status (3. 7% ) and 71 were dead (32. 6% ) in normathermia group (P 0. 05). Intracranial pressure decreased faster and less in mild hypothermia group than in normathermia group (P0.05). Furthermore, the incidence of stress ulcer and epilepsy in mild hypothermia group was lower than those in normathermia group ( P 0. 05) . However, the incidence of pulmonary infection, intracranial infection and cardiac arrhythmia was not significantly different between two groups (P0.05). Conclusion Mlid hypothermia significantly improves the outcome of severe traumatic brain injured patients with severe cerebral contusion and intracranial hypertension without significant complications.
【Fund】: 国家自然科学基金(39570717)资助项目
【CateGory Index】: R651.15
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