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Titre du document / Document title

Effect of long-term mild hypothermia or short-term mild hypothermia on outcome of patients with severe traumatic brain injury

Auteur(s) / Author(s)

JIANG Ji-Yao (1) ; WEI XU (2) ; LI Wei-Ping (3) ; GAO Guo-Yi (1) ; BAO Ying-Hui (1) ; LIANG Yu-Min (1) ; LUO Qi-Zhong (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Neurosurgery, Renji Hospital, Shanghai Second Medical University, Shanghai, CHINE
(2) Department of Neurosurgery, Second Teaching Hospital of Kuming Medical College, Yuennan Province, CHINE
(3) Department of Neurosurgery, Shenzheng Second People's Hospital, Guangdong Province, CHINE

Résumé / Abstract

To compare the effect of long-term mild hypothermia versus short-term mild hypothermia on the outcome of 215 severe traumatic brain injured patients with cerebral contusion and intracranial hypertension. At three medical centers, 215 patients aged 18 to 45 years old with an admission Glasgow Coma Scale ≤8 within 4h after injury were randomly divided into two groups: long-term mild hypothermia group (n=108) for 5±1.3 days mild hypothermia therapy and short-term mild hypothermia group (n=107) for 2±0.6 days mild hypothermia therapy. All patients had intracranial hypertension and frontotemporoparietal contusion with midline shift > 1 cm confirmed on computed tomographic scan. Glasgow Outcome Scale at 6-month follow-up, 47 cases had favorable outcome (43.5%), and other 61 cases had unfavorable outcome (56.5%) in the long-term mild hypothermia group. However, only 31 cases had favorable outcome (29.0%), and other 76 cases had unfavorable outcome (71.0%) in the short-term mild hypothermia group (P<0.05). The intracranial pressure significantly rebounded after rewarming in the short-term mild hypothermia group, but not in the long-term mild hypothermia (P<0.05). Furthermore, the incidence of stress ulcer, epilepsy, pulmonary infection, intracranial infection did not significantly differ between the two groups (P>0.05). Compared with short-term mild hypothermia, long-term mild hypothermia significantly improves the outcome of severe traumatic brain injured patients with cerebral contusion and intracranial hypertension without significant complications. Our data suggest that 5 days of long-term cooling is more efficacious than 2 days of short-term cooling when mild hypothermia is used to control refractory intracranial hypertension in patients with severe traumatic brain injury.

Revue / Journal Title

Journal of cerebral blood flow and metabolism    ISSN  0271-678X   CODEN JCBMDN 

Source / Source

2006, vol. 26, no6, pp. 771-776 [6 page(s) (article)] (1 p.1/4)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing Group, New York, NY, ETATS-UNIS  (1981) (Revue)

Mots-clés anglais / English Keywords

Central nervous system disease

;

Cerebral disorder

;

Craniocerebral

;

Human

;

Prognosis

;

Short term

;

Intracranial hypertension

;

Contusion

;

Head trauma

;

Hypothermia

;

Cerebrovascular disease

;

Nervous system diseases

;

Mots-clés français / French Keywords

Système nerveux central pathologie

;

Encéphale pathologie

;

Crânioencéphalique

;

Homme

;

Pronostic

;

Court terme

;

Hypertension intracrânienne

;

Contusion

;

Traumatisme crânien

;

Hypothermie

;

Cérébrovasculaire pathologie

;

Système nerveux pathologie

;

Mots-clés espagnols / Spanish Keywords

Sistema nervosio central patología

;

Encéfalo patología

;

Craneoencefálico

;

Hombre

;

Pronóstico

;

Corto plazo

;

Hipertensión intracraneal

;

Contusión

;

Traumatismo craneoencefálico

;

Hipotermia

;

Vaso sanguíneo encéfalo patología

;

Sistema nervioso patología

;

Mots-clés d'auteur / Author Keywords

contusion

;

cooling

;

head injury

;

head trauma

;

intracranial hypertension

;

outcome

;

Localisation / Location

INIST-CNRS, Cote INIST : 19142, 35400015668917.0040

Nº notice refdoc (ud4) : 17838436



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