Mild Hypothermia Therapy On The Efficacy And Safety In Patients With Severe Traumatic Brain Injury : A Systematic Review

Objectives Analysis and evaluation of mild hypothermia therapy on mortality and prognosis of patients with severe craniocerebral injury with mild hypothermia in the treatment of security.Methods According to the cochrane systematic review methods, The data bases such as Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and Vip database were searched. Retrieves the deadline is July 12, 2013, based on inclusion and exclusion criteria, Screening with sever traumatic brain injury as the research object of clinical randomized controlled trials, And manually retrieve literature references, magazine supplement, and conference abstracts. Assess the quality of included documents, extracting meta analysis data using the Revman5.2 software.Results 12 mild hypothermia treatment of severe traumatic brain injury of randomized controlled trials met the inclusion criteria, 3 of which for the multicenter study, 9 were single centre study, covering 1003 patients with hypothermia treatment group, 999 patients with control group. Meta analysis shows that sub-hypothermia group compared to normal temperature group reduces the overall case-fatality rate[RR=0.74, 95%CI(0.64, 0.85), P<0.0001]; Sub-hypothermia group compared to normal temperature group improved outcomes[RR=1.40, 95%CI(1.24, 1.59), P<0.00001]; Hypothermia treatment 1, 3, 7 day of intracranial pressure and blood sugar were lower than the control group<0.05, Incidence of pneumonia P=0.007, the difference was statistically significant; Incidence of arrhythmia P=0.06, No statistically significant differences, but the difference was statistically significant after sensitivity analysis.Conclusions Mild hypothermia for the duration of <3 days is not valid, the duration of up to 3 days may not reduce mortality rates, but you can improve the prognosis(GOS score 4~5), lasts longer than 3 days or until the pressure back to normal, reducing the mortality rate, improve the neurological prognosis; During mild hypothermia treatment may reduce intracranial pressure and blood sugar, but increased incidence of pneumonia, whether to increase the rate of cardiac arrhythmias have yet to be determined.