Therapeutic Hypothermia: Its Potential and Questionable Role in Traumatic Brain Injury
From the acute management of cardiac arrest and stroke to traumatic brain injury, the implementation of hypothermia therapy since the past two decades has progressed from various guidelines committees' consideration of minimal benefit to mixed favorable outcomes being obtained from numerous randomized controlled trials. As far as cases of traumatic brain injury are concerned, there were evidences of positive benefit in terms of mortality rates and neurological outcomes. According to a systematic analysis by Peterson et al. (2008), the relative risks (RR) of mortality (95% confidence interval) in comparison with control treatment groups were lower in subgroups of hypothermic procedures which utilized a cooling duration of over 48 hours (RR = 0.51), delivered at a temperature range of 33 degrees Celsius and above that was defined as milder than below 33 degrees Celsius (RR = 0.77), and when the patient was rewarmed passively (RR = 0.49).