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《Chinese Journal of Minimally Invasive Neurosurgery》 2009-05
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A Meta analysis of hypothermia for severe traumatic brain injury

LIU Guodong, LAN Qing Department of Neurosurgery, Second Affiliated Hospital to Soochow University, Suzhou 215000, China  
Objective To comprehensively evaluate the clinical efficacy and complications of hypothermia for severe traumatic brain injury and its effects on intracranial pressure(ICP).Methods The data bases such as Ovid, PubMed, Cochrane Database of Systematic Reviews, EMBASE, CBM, CJFD, Wanfang Data, and Vip Fulltext Databse were searched extensively according to the criteria established for original articles.Following the methodological quality of 8 screened randomized controlled trails(RCT) was assessed, Meta analysis was performed with software Review Manager 4.2.8 for the difference in mortality, Glasgow Outcome Scale(GOS), changing of ICP and complications between hypothermia group and normal temperature group.Results Publication bias was not found through funnel plot analysis.ICP was significantly lower in the hypothermia group in the control group 24 h after treatment(WMD =-2.92, 95%CI:-3.49 to-2.34,P 0.000 1).In comparison with the routine therapy,hypothermia could significantly decrease mortality(P = 0.001, OR = 0.66, 95%CI:0.51 to 0.84) and improve GOS(P0.000 01, OR = 0.56, 95%CI:0.44 to 0.70), but increase the incidence of pneumonia(OR = 1.55, 95%CI:1.13 to 2.12) and cardiac arrhythmia(OR = 2.14, 95%CI:1.30 to 3.52).Conclusion Therapeutic hypothermia can reduce the mortality, improve neurological outcome and efficaciously decrease ICP in patients with severe traumatic brain injury, but can also increase the risk of pneumonia and cardiac arrhythmia compared with control group.
【CateGory Index】: R651.15
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