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Curr Opin Crit Care · Apr 2004
ReviewIs keeping cool still hot? An update on hypothermia in brain injury.
- Guy L Clifton.
- The University of Texas Medical School at Houston, Houston, Texas 77030, USA. Guy.L.Clifton@uth.tmc.edu
- Curr Opin Crit Care. 2004 Apr 1; 10 (2): 116-9.
Purpose Of ReviewThe purpose of this review is to examine recent research results for hypothermia as a treatment for brain injury.Recent FindingsOne potential application for hypothermia is as a means of control of elevated intracranial pressure in which hypothermia is induced when intracranial pressure becomes uncontrollable by conventional means. A second application is as a neuroprotectant in which hypothermia is induced very early and maintained for a specified period as a means of diminishing the biochemical cascade that produces secondary brain injury. The clinical data indicate that hypothermia reduces elevated intracranial pressure, but no conclusion can be drawn as to whether this improves outcome over existing techniques (eg, mannitol and barbiturates). There is little evidence that hypothermia acts as a neuroprotectant in trials, all of which used treatment windows of over 4 hours.SummaryHypothermia is a useful adjunct to barbiturates and mannitol to control elevated intracranial pressure. The results of trials that have tested systemic hypothermia as a neuroprotectant have been negative or equivocal, and cooling may have been induced outside the treatment window.
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