Brain injured children and cooling

Hypothermia therapy does not improve the neurologic outcome and may increase mortality in children with severe traumatic brain injury, warn Canadian researchers.

They randomly assigned 225 children with severe traumatic brain injury to either hypothermia therapy (32.5°C for 24 hours) initiated within eight hours after injury or to normothermia (37.0°C). They measured the proportion of children who had an unfavourable outcome, such as severe disability, persistent vegetative state, or death six months later.

After follow-up, they found 31% of the patients in the hypothermia group, as compared with 22% of the patients in the normothermia group, had an unfavourable outcome. This included 23 deaths in the hypothermia group and 14 deaths in the normothermia group.

Lengths of stay in the intensive care unit and in the hospital and other adverse events were similar in the two groups, the authors added.

New England Journal of Medicine (2008) 358: 2447-2456