Effects of Mild Hypothermia on Patients with Lower Intracranial Pressure Following Severe Brain Injury

Aug 31, 2026

Upload by Asher

Objective: assess whether mild hypothermia provides additional benefits for severe brain-injured patients when intracranial pressure (ICP) can be kept below 25 mm Hg by conventional therapy. Methods: forty patients with GCS≤8 were randomized into mild hypothermia and normothermia groups (n=20 each), and CSF levels of excitatory amino acids (glutamate, glycine) and cytokines (interleukin-1β, interleukin-6) were monitored. Results: no significant intergroup differences were found in measured biochemical changes or outcomes. Conclusions: mild hypothermia showed no added benefit versus normothermia under strict ICP control.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Objective

Methods

Patients and grouping

Hypothermia therapy

Outcome assessment

Statistical analysis

Results

Cerebrospinal fluid analysis

Prognosis assay

Conclusions

Effects of mild hypothermia on patients with lowerintracranial pressure following severe brain injury WANG Wei-ping王维平’,REN Hai-jun任海军，CHI Jing-yang池京洋，XU Fu-lin徐福林and QUAN Yong全勇 daily changes of the concentration of excitatory amino acidand cytokines between two groups.The outcome of twogroups had no significant differences. Objective:To study the effects of mild hypothermiatherapy on severe brain-injured patients whose intracranialpressure(ICP)could be maintained below 25 mm Hg. Conclusions: Mild hypothermia has no additionalbeneficial effects on severe brain-injured patients comparedwith normothermia therapy if ICP can be maintained below25 mm Hg by using conventional therapy. Methods:Forty severe brain-injured patients withICP below 25 mm Hg were divided randomly into onetreatment group(n=20,mild hypothermia therapy)andone control group(n =20,normothermia therapy)toobserve the changes of the concentration of excitatory aminoacids(glutamate and glycine)and cytokines(interleukin-1β and interleukin-6). Key words: Brain injury;Intracranial pressure;Hypothermia Chin J Traumatol 2005;8(1):54-56 Results:There were no significant differences in the # METHODS n recent 10 years,mild hypothermia therapy hasbeen used for treatment of the patients with severebrain injury.However,the criterion of therapy hasnot been standardized.At present,there are differentopinions about mild hypothermia therapy.In 1998,Shiozakz and colleagues reported that mild hypothermiawas effective in preventing ICP elevation in patientswith ICP level higher than 20 mm Hg but less than40 mm Hg after conventional therapies.¹Up to now,there are no conclusions about whether mildhypothermia therapy has any advantage overnormothermia therapy in patients whose ICP can bemaintained at lower than 25 mm Hg by usingconventional therapy.We observed the effect of mildtherapeutic hypothermia on patients with lowerintracranial pressure following severe brain injury. # Patients and grouping Forty severe brain-injured patients(GCS≤8)were admitted to our hospital within 24 hours afterinjury.Emergency operation and/or conventionaltherapy(mannitol,corticosteroid and barbituratetherapy)were administered after which ICP levels ofpatients were lower than 25 mm Hg(mean 20.8mm Hg).The patients were randomly dividedinto two groups.the mild hypothermia group(HTgroup,20 patients)and the normothermia group(NTgroup,20 patients).There were no obviousdifferences in patients'condition such as age,sex,thelevel of ICP as well as other therapy between twogroups. All patients were initially intubated and treatedwith fluid restriction at 1 ml·kg-¹·h-¹.Afterinjury,standard computerized tomography(CT)scanof the head was obtained for every patient.Intraventricular catheter was placed in each patient forcontinuous ICP monitoring and intracranial temperaturemonitoring. Department of Neurosurgery,Minhang Hospital of RuijinHospital Groups,Shanghai 201100,China(Wang WP,ChiJY,Xu FL and Quan Y) Department of Neurosurgery,The 2nd Hospital of IanzhouMedical College(Ren HJ) # Hypothermia therapy *Corresponding author:Tel:86-21-64923400 ext 5101,E-mail:wpwang222@tom.com Mild hypothermia was induced in the HT group as # Outcome assessment quickly as possible by cooling the body surface withwater-circulating blankets placed above and below thebody.The intracranial temperature was maintained at Outcome assessment was evaluated according toGlasgow Coma Scale(GCS)and the prognosticstandard was evaluated at 6 months after injury. 33.5℃-34.5℃ for 48 hours by continuous infusion ofbarbiturates(6 to 8mg·kg⁻¹·h⁻¹).After 2 days,the patients were rewarmed spontaneously(approximately 1℃/d)by continuous infusion ofbarbiturates(2 mg·kg⁻¹·h⁻¹)to prevent shivering.After 5 days,the intracranial temperature reached37℃ in the HT group.When the rewarming wascompleted,the barbiturates were gradually stopped.Normothermia was induced in the NT group with theintracranial temperature of 37℃.Bar

FAQs

What was the study objective regarding mild hypothermia and intracranial pressure?

To determine whether mild hypothermia therapy offers additional benefits for severe brain-injured patients when ICP is maintained below 25 mm Hg by conventional therapy.

How were patients grouped and what treatments were compared?

Forty severe brain-injured patients (GCS≤8) were randomized into a mild hypothermia group and a normothermia group, each with n=20, with both groups managed using conventional therapy to keep ICP below 25 mm Hg.

What endpoints were used to evaluate effects of treatment?

CSF concentrations of excitatory amino acids (glutamate, glycine) and cytokines (interleukin-1β, interleukin-6) were assessed over time, and prognosis was evaluated using GOS at 6 months after injury.

Aug 31, 2026

Upload by Asher