title: Local mild hypothermia therapy as an augmentation strategy for minimally invasive surgery of hypertensive intracerebral hemorrhage: a meta-analysis of randomized clinical trials.
abstract: BACKGROUND
  Previous studies reported that the mild hypothermia therapy (MHT) could significantly improve the clinical outcomes for patients with hypertensive intracerebral hemorrhage (HICH). Therefore, this meta-analysis was conducted to systematically assess whether the addition of local MHT (LMHT) could significantly improve the efficacy of minimally invasive surgery (MIS) in treating HICH.
  
  
  METHODS
  Randomized clinical trials on the combined application of MIS and LMHT (MIS+LMHT) vs MIS alone for treating HICH were searched up to September 2016 in databases. Response rate and mortality rate were the primary outcomes, and the neurologic function and Barthel index were the secondary outcomes. Side effects were also analyzed.
  
  
  RESULTS
  Totally, 28 studies composed of 2,325 patients were included to compare the efficacy of MIS+LMHT to MIS alone. The therapeutic effects of MIS+LMHT were significantly better than MIS alone. The pooled odds ratio of response rate and mortality rate was 2.68 (95% confidence interval [CI]=2.22-3.24) and 0.43 (95% CI=0.32-0.57), respectively. In addition, the MIS+LMHT led to a significantly better improvement in the neurologic function and activities of daily living. The incidence of pneumonia was similar between the two treatment methods.
  
  
  CONCLUSIONS
  These results indicated that compared to MIS alone, the MIS+LMHT could be more effective for the acute treatment of patients with HICH. This treatment modality should be further explored and optimized.
authors.affiliation: Department of Neurology.
authors.forename: Yu
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Neurology.
authors.forename: Ke
authors.initials: K
authors.lastname: Sheng
authors.affiliation: Department of Neurology.
authors.forename: Meilan
authors.initials: M
authors.lastname: Su
authors.affiliation: Department of Neurology.
authors.forename: Nan
authors.initials: N
authors.lastname: Yang
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wan
keywords: Barthel index; HICH; LMHT; neurologic function; pneumonia