Effects of selective brain cooling in patients with severe traumatic brain injury: a preliminary study.
We prospectively investigated non-invasive selective brain cooling (SBC) in patients with severe traumatic brain injury. Sixty-six in-patients were randomized into three groups. In one group, brain temperature was maintained at 33 - 35 degrees C by cooling the head and neck (SBC); in a second group, mild systemic hypothermia (MSH; rectal temperature 33 - 35 degrees C) was produced with a cooling blanket; and a control group was not exposed to hypothermia. Natural rewarming began after 3 days. Mean intracranial pressure 24, 48 or 72 h after injury was significantly lower in the SBC group than in the control group. Mean serum superoxide dismutase levels on Days 3 and 7 after injury in the SBC and MSH groups were significantly higher than in the control group. The percentage of patients with a good neurological outcome 2 years after injury was 72.7%, 57.1% and 34.8% in the SBC, MSH and control groups, respectively. Complications were managed without severe sequelae. Non-invasive SBC was safe and effective.
Liu
W G
WG
Department of Neurosurgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, China.
Qiu
W S
WS
Zhang
Y
Y
Wang
W M
WM
Lu
F
F
Yang
X F
XF
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D006259:Craniocerebral Trauma / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D007036:Hypothermia, Induced; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017694:Rewarming; D013482:Superoxide Dismutase / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D013482:Superoxide Dismutase