Modest cooling therapies (35 degrees C to 37.5 degrees C) for traumatic brain injury.
BACKGROUND
A recent retrospective study suggested that after traumatic brain injury, patients with a raised body temperature have an unfavourable outcome compared to patients that have a normal body temperature.


OBJECTIVE
To assess the effects of modest cooling therapies (defined as any drug or physical therapy aimed at maintaining body temperature between 35 degrees C and 37.5 degrees C) when applied to patients in the first week after traumatic brain injury.


METHODS
We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 3), MEDLINE (1950 to 2008), EMBASE (1980 to 2008), the National Research Register, Zetoc and the Current Controlled Trials MetaRegister of controlled trials. We also contacted investigators, pharmaceutical companies and the manufacturers of cooling equipment. The searches were conducted August to September 2007 and updated in April 2008.


METHODS
All completed randomised, controlled or placebo-controlled trials published or unpublished, where modest cooling therapies were applied in the first week after traumatic brain injury.


METHODS
Two authors independently searched for relevant trials.


RESULTS
We were unable to find any randomised, placebo-controlled trials of modest cooling therapies after traumatic brain injury.


CONCLUSIONS
There is no evidence that interventions aimed at reducing body temperature to between 35 degrees C and 37.5 degrees C in the first week after TBI improves patient outcomes. Trials designed to explore the effect of these interventions on patient-centred outcomes are needed.
Saxena
Manoj
M
Intensive Care, St George Hospital, Gray St, Kogarah, Sydney, NSW, Australia, 2217. m.saxena@unsw.edu.au
Andrews
Peter J D
PJ
Cheng
Andrew
A
D001831:Body Temperature; D001930:Brain Injuries / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*