Effects of mild hypothermia in secondary brain injury in patients with severe brain injury

Abstract

Objective To evaluate the effect of mild hypothermia combined with hypbaric oxygen (HBO) treatment on secondary brain injury in patients with severe craniocerebral injury. Methods A prospective study was conducted in this study. Forty-two patients with severe craniocerebral injury admitted to hospital within 8 hours were randomly divided into sub-hypothermia combined with HBO treatment group and conventional HBO control group, 21 cases in either group. Cerebral hemorrhage and brain edema were calculated by reviewed head CT on the 1st day, 15th day and 30th day after injury. GCS (Glasgow Coma Scale) score was calculated at the same time. The number of cases of cerebral infarction was counted in the two groups. GOS (Glasgow Outcome Score) prognosis was scored for both groups of patients six months after injury. Two groups of sample rates were compared using a chi-square test with continuous correction, The intergroup comparisons were analyzed by independent sample t test by using SPSS version 13.0 software.Differences were considered statistically significant if P<0.05. Results (1) The amount of cerebral hemorrhage and edema in the treatment group were significantly lower than those in the control group on the 15th day and 30th day after injury [(21.71±4.3)vs.(26.33±5.23); (14.33±1.93)vs.(16.86±2.86), P<0.05]. (2) The GCS score of the treatment group was higher than that of the control group on the 15th day and 30th day after injury[ (4.62±0.49) vs.(2.49±0.56); (9.76±1.37)vs.(8.57±0.92), P<0.05]; (3) There were 2 cases of traumatic cerebral infarction in the treatment group and 9 cases in the control group (χ2=4.434, P=0.035). The GOS score in the treatment group was higher than that in the control group six months after injury[(4.29±0.84)vs.(3.38±0.74), P=0.001]. Conclusions Mild hypothermia combined with hyperbaric oxygen treatment can reduce the secondary brain injury and improve the prognosis of patients with severe craniocerebral injury. It is worth further study, the mechanism of hypothermia remains to be further studied. Key words: Mild hypothermia; Hyperbaric oxygen; Severe craniocerebral injury; Secondary brain injury; Temperature management; Cerebral infarction; Glasgow Coma Scale; Glasgow Outcome Score