Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury.
OBJECTIVE
To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury (TBI).


METHODS
Ninety-six inpatients with severe brain injury were randomized into three groups: SBC (selective brain cooling) group (n=24), MSH (mild systemic hypothermia) group (n=30), and control (normothermia) group (n=42). The platelet counts and prognosis were retrospectively analyzed.


RESULTS
Thrombocytopenia was present in 18 (75%), 23 (77%) and 15 (36%) patients in SBC group, MSH group and control group, respectively (P<0.01). Thrombocytopenia, in which the minimum platelet count was seen 3 days after hypothermia, showed no significant difference between SBC and MSH group (P>0.05). Most platelet counts (37 cases, 90%) in hypothermia group were returned to normal level after 1 to 2 days of natural rewarming. The platelet count in SBC group reduced by 16%, 27% and 29% at day 1, 3 and 5 respectively compared with the baseline value. Good recovery (GOS score 4-5) rate of thrombocytopenia 1 year after injury for hypothermia group (17 cases, 37%) was significantly lower than that of control group (P<0.01).


CONCLUSIONS
Therapeutic hypothermia increases the incidence of thrombocytopenia in severe TBI, and patients with thrombocytopenia after therapeutic hypothermia are associated with unfavorable neurological prognosis.
Qiu
Wu-si
WS
Department of Neurosurgery, 2nd Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou 310009, China. shihai954@163.com
Wang
Wei-min
WM
Du
Hong-ying
HY
Liu
Wei-guo
WG
Shen
Hong
H
Shen
Lei-fen
LF
Zhu
Ming-lan
ML
D000328:Adult; D001930:Brain Injuries / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013921:Thrombocytopenia / Q000209:etiology*