Lowering body temperature can help control brain swelling and intracranial pressure, which can also exacerbate secondary injury if left unchecked. Induced hypothermia can be accomplished using several methods. Surface cooling methods such as cooling blankets placed under and on top of patients and ice packs placed in the groin and armpit areas are effective in decreasing temperature.
In addition to safety, mortality and complications during the treatment protocol and during hospitalization, the study also assessed functional and cognitive outcome in these children with severe traumatic brain injury.
After severe TBI, 48 children less than 13 years of age admitted within six hours of injury were randomized by age to moderate hypothermia treatment in conjunction with standardized head injury management versus normal body temperature.
An additional 27 patients were entered into a parallel trial of those patients who were excluded because there was a delay in transfer of greater than six hours following injury but within 24 hours of admission, or unknown time when the injury occurred (i.e. child abuse) or were an adolescent (13-18 years old).
Assessments of safety included mortality, infection, coagulopathy (blood clotting), arrhythmias and hemorrhage as well as ability to maintain target temperature, mean intracranial pressure (ICP), and percent time of ICP less than 20 mm Hg during the cooling and subsequent rewarming phases. Additionally, assessments of neurocognitive outcomes were obtained at three and six months of follow-up. Researchers will conduct further studies to determine the effect of moderate hypothermia on functional outcome and intracranial hypertension.