Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury

Q: What was the study objective regarding thrombocytopenia?

To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury.

Q: How were patients grouped and treated?

Ninety-six patients were randomized into SBC (selective brain cooling), MSH (mild systemic hypothermia), and control (normothermia) groups, with hypothermia-related protocols applied accordingly.

Q: When did the platelet count reach its lowest point, and did SBC differ from MSH?

The minimum platelet count was seen 3 days after hypothermia, and there was no significant difference between the SBC and MSH groups at this nadir.

Aug 31, 2026

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Severe traumatic brain injury patients receiving therapeutic hypothermia were studied to clarify the clinical characteristics and significance of post-treatment thrombocytopenia. Ninety-six inpatients were randomized to selective brain cooling (SBC), mild systemic hypothermia (MSH), or normothermia control groups, and platelet counts with outcomes were analyzed retrospectively. Thrombocytopenia occurred more frequently in SBC and MSH groups than controls, with the nadir around day 3, and thrombocytopenia after hypothermia related to unfavorable 1-year neurological recovery.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

METHODS

Patients

Management

Monitoring parameters

Statistical analysis

QIU Wu-si裘五四*,WANG Wei-min王卫民，DU Hong-ying杜红英，LIU Wei-guo刘伟国，SHEN Hong沈宏，SHEN Lei-fen沈磊芬and ZHU Ming-lan祝鸣兰 Objective: To investigate the clinical characteristicsand significance of thrombocytopenia after therapeutichypothermia in severe traumatic brain injury(TBI). Methods: Ninety-six inpatients with severe braininjury were randomized into three groups;SBC(selectivebrain cooling)group(n=24),MSH(mild systemichypothermia ) group (n=30),and control(normothermia)group(n=42).The platelet counts andprognosis were retrospectively analyzed. Results:Thrombocytopenia was present in 18(75%),23(77%)and 15(36%)patients in SBC group,MSH group and control group,respectively(P<0.01).Thrombocytopenia,in which the minimum platelet countwas seen 3 days after hypothermia,showed no significantdifference between SBC and MSH group(P>0.05).Most P latelet count is a variable of great interest forphysicians in the intensive care unit for traumaticbrain injury(TBI).¹³Therapeutic hypothermiais still one of the effective measures for brain protectionand reducing mortality in severe TBI though thecomplications such as secondary infections,shock mayemerge during rewarming and thrombocytopenia.³Controversy still exists on the alteration of plateletcount after hypothermia.In this study,we investigatedthe platelet changes during hypothermia treatment inpatients with severe TBI,and the clinicalcharacteristics of thrombocytopenia and the relativeprophylactic-therapeuticmeasureagainstthrombocytopenia. Department of Neurosurgery,2nd Affiliated Hospital ofSchool of Medicine,Zhejiang University,Hangzhou 310009,China(Qiu WS,Liu WG,Shen H and Zhu ML) Department of Neurosurgery,Hangzhou Second HospitalAffiliated to Hangzhou Normal College,Hangzhou 310012,China(Qiu WS,Wang WM,Du HY and Shen LF) *Coresponding author:Tel:86-571-87783757,E-mail:shihai954@163.com # Thrombocytopenia after therapeutic hypothermia in severetraumatic brain injury platelet counts(37 cases,90%)in hypothermia group werereturned to normal level after 1 to 2 days of naturalrewarming.The platelet count in SBC group reduced by16%,27%and 29%at day 1,3 and 5 respectivelycompared with the baseline value.Good recovery(GOSscore 4-5)rate of thrombocytopenia 1 year after injury forhypothermia group(17 cases,37%)was significantly lowerthan that of control group(P<0.01). Conclusions:Therapeutic hypothermia increases theincidence of thrombocytopenia in severe TBI,and patientswith thrombocytopenia after therapeutic hypothermia areassociated with unfavorable neurological prognosis. Key words:Traumatic brain injury;Hypothermia;Thrombocytopenia;Prognosis Chin J Traumatol 2006;9(4):238-241 ## METHODS Patients Between October 2001 and October 2003,96patients(64 males and 32 females,aged 19-63 years,mean:41.3 years±11.7 years)with severe TBI wereenrolled in this study.The patients were categorizedinto three groups as follows:SBC(selective braincooling)group(n=24),MSH(mild systemichypothermia) group (n=30),and control(normothermia)group(n=42).³All he patientswere met the following criteria:the history of TBI,Glasgow Comma Scale(GCS)≤8 scores,brain injuryappeared on sequential computerized tomography(CT)within 1-24 hours(mean 8.6 hours).Pregnantwoman,children below 14 years old,those withhemorrhagic shock,hematologic diseases such asleukemia and other serious visceral diseases wereexcluded.The demography and clinical data of thepatients were comparable(Table 1). | | Table 1. Clinical characteristics of patients with severe TBI in 3 groups | | | | | | | --- | --- | --- | --- | --- | --- | --- | | Groups | n | Gender MF | Mean age
(years) | Injury type
Traffic accident/others | GCS 3-5/
≥6 | Surgery
yes/no | | SBC | ·24 | 15/9 | 37.4 | 18/6 | 12/12 | 17/7 | | MSH | 30 | 19/11 | 40.1 | 19/11 | 17/13 | 18/12 | | CON | 42 | 30/12 | 44.3 | 30/12 | 13/19 | 25/17 | SBC:selective brain cooling,MSH:mild s

FAQs

What was the study objective regarding thrombocytopenia?

To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury.

How were patients grouped and treated?

Ninety-six patients were randomized into SBC (selective brain cooling), MSH (mild systemic hypothermia), and control (normothermia) groups, with hypothermia-related protocols applied accordingly.

When did the platelet count reach its lowest point, and did SBC differ from MSH?

The minimum platelet count was seen 3 days after hypothermia, and there was no significant difference between the SBC and MSH groups at this nadir.

Aug 31, 2026

Uploaded by Evangeline