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Semin Respir Crit Care Med 2017; 38(06): 768-774
DOI: 10.1055/s-0037-1607989
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Future Directions for Hypothermia following Severe Traumatic Brian Injury

Annie W. Chiu
1   Department of Neurocritical Care, Neurology, and Emergency Medicine, Oregon Health & Science University, Portland, Oregon
,
Holly E. Hinson
1   Department of Neurocritical Care, Neurology, and Emergency Medicine, Oregon Health & Science University, Portland, Oregon
› Author Affiliations
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Publication History

Publication Date:
20 December 2017 (online)

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Abstract

Traumatic brain injury (TBI) is a serious health care problem on both individual and public health levels. As a major cause of death and disability in the United States, it is associated with a significant economic and public health burden. Although the evidence to support the use of induced hypothermia on neurologic outcome after cardiac arrest is well established, its use in treating TBI remains controversial. Hypothermia has the potential to mitigate some of the destructive processes that occur as part of secondary brain injury after TBI. Hypothermia can be helpful in lowering intracranial pressure, for example, but its influence on functional outcome is unclear. There is insufficient evidence to support the broad use of prophylactic hypothermia for neuroprotection after TBI. Investigators are beginning to more carefully select patients for temperature modulating therapies, in a more personalized approach. Examples include targeting immunomodulation and scaling hypothermia to achieve metabolic targets. This review will summarize the clinical evidence for the use of hypothermia to limit secondary brain injury following acute TBI.

Keywords

hypothermia - cooling - fever - traumatic brain injury - intracranial pressure
 

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