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 Vol. 20 No. 3, September 2008
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AAP Grand Rounds 20:28-29 (2008)
© 2008 American Academy of Pediatrics

CRITICAL CARE

Hypothermia for Traumatic Brain Injury

Source: Hutchison JS, Ward RE, Lacroix J, et al. Hypothermia therapy after traumatic brain injury in children. N Engl J Med. 2008;358(23):2447–2456; doi:10.1056/NEJMoa0706930[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: In children with severe traumatic brain injury does elective hypothermia improve outcomes?

Question type: Intervention

Study design: Randomized controlled trial

 

Canadian investigators performed a randomized trial between 1999 and 2004 to determine if elective hypothermia is better than normothermia (37.0° C) at preventing adverse outcomes in children with severe traumatic brain injury (TBI).

Children aged 1–17 years with a Glasgow Coma Scale (GCS) of ≤ 8 were enrolled. Patients randomized to hypothermia were cooled with surface cooling techniques until they had esophageal temperatures of 32.5° ± 0.5°C for 24 hours.

After rewarming those in the hypothermia group (at a rate of 0.5°C every two hours), and beginning immediately for the normothermia group, core temperature was maintained at 37.0° ± 0.5°C until intracranial hypertension resolved.

The . . . [Full Text of this Article]

Michelle Zebrack, MD, FAAP
Pediatrics, Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT and Pediatrics, Cardiovascular Intensive Care Medicine, Stanford University School of Medicine, Palo Alto, CA