For patients with traumatic brain injury, therapeutic hypothermia plus standard care does not improve outcomes, according to a study published in the New England Journal of Medicine. “Therapeutic hypothermia plus standard care to reduce intracranial pressure did not result in outcomes better than those with standard care alone,” the authors write.
Peter J.D. Andrews, MD, MB, ChB, from the University of Edinburgh in the United Kingdom, and colleagues examined the effect of hypothermia on functional outcome in patients with TBI. Adults with an intracranial pressure of more than 20 mm Hg despite stage 1 treatments were randomized to standard care or hypothermia plus standard care.
Owing to safety concerns, the study was suspended in October 2014 after enrollment of 387 patients. The researchers found that 54 and 44% of patients in the control and hypothermia groups required stage 3 treatments to control intracranial pressure. For the Extended Glasgow Outcome Scale, the adjusted common odds ratio was 1.53 (P = 0.04), suggesting worse outcome in the hypothermia group. A favorable outcome occurred in 26 and 37% of the hypothermia and control groups, respectively (P = 0.03).