Abstract
Traumatic brain injury (TBI) is a serious health care problem on both individual and
public health levels. As a major cause of death and disability in the United States,
it is associated with a significant economic and public health burden. Although the
evidence to support the use of induced hypothermia on neurologic outcome after cardiac
arrest is well established, its use in treating TBI remains controversial. Hypothermia
has the potential to mitigate some of the destructive processes that occur as part
of secondary brain injury after TBI. Hypothermia can be helpful in lowering intracranial
pressure, for example, but its influence on functional outcome is unclear. There is
insufficient evidence to support the broad use of prophylactic hypothermia for neuroprotection
after TBI. Investigators are beginning to more carefully select patients for temperature
modulating therapies, in a more personalized approach. Examples include targeting
immunomodulation and scaling hypothermia to achieve metabolic targets. This review
will summarize the clinical evidence for the use of hypothermia to limit secondary
brain injury following acute TBI.
Keywords
hypothermia - cooling - fever - traumatic brain injury - intracranial pressure
