Pre-hospital mild therapeutic hypothermia for patients with severe traumatic brain injury

ABSTRACT

Background

We aimed to assess the effects of pre-hospital mild therapeutic hypothermia (MTH) on patients with severe traumatic brain injury (sTBI).

Methods

Eighty-six patients with sTBI were prospectively enrolled into the pre-hospital MTH group and the late MTH group (initiated in hospital). Patients in the pre-hospital MTH group were maintained at a tympanic temperature of 33°C–35°C before admission and continued to be treated with a therapeutic hypothermia device for 4 days. Patients in the late MTH group were treated with the same MTH parameters. Intracranial pressure (ICP), complications and Glasgow Outcome Scale (GOS) scores were monitored.

Results

ICP was significantly lower for patients in the pre-hospital MTH group 24, 48, and 72 h after treatment (17.38 ± 4.88 mmHg, 18.40 ± 4.50 mmHg, and 16.40 ± 4.13 mmHg, respectively) than that in the late MTH group (20.63 ± 3.00 mmHg, 21.80 ± 6.00 mmHg, and 18.81 ± 4.50 mmHg) (P < .05). The favorable prognosis (GOS scores 4–5) rate in the pre-hospital MTH group was higher tha n the late MTH group (65.1% vs. 37.2%, respectively; P < .05) without complications .

Conclusion

Pre-hospital MTH for patients with STBI can reduce ICP and improve neurological outcomes.

KEYWORDS:

• Traumatic brain injury
• mild therapeutic hypothermia
• intracranial pressure
• prognosis

Acknowledgments

The present study was supported by the Scientific Research Fund of Affiliated Hospital Hangzhou Normal University, the Science and Technology Department of Hangzhou, China (No.20120533Q22, 20150733Q18,20191203B103). The authors gratefully acknowledge the Second Affiliated Hospital of Zhejiang University.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Science and Technology Department of Hangzhou, China [20120533Q22,20150733Q18,20191203B103].