Effects of mild hypothermia on caspase-3 and cytochrome c levels in cerebrospinal fluid and its prognosis in patients with severe traumatic brain injury

Abstract

Objective To investigate the protective effect of mild hypothermia on severe traumatic brain injury and the effects on cytochrome c (CytC) and caspase-3 levels in cerebrospinal fluid (CSF). Methods 95 patients with severe brain injury admitted into our hospital from January, 2016 to April, 2017 were selected, and divided into a control group (44 cases) and a mild hypothermia group (51 cases). The differences in CytC level, caspase-3 level and intracranial pressure (ICP) of CSF in the two groups on the 1st, 3rd, and 7th day after treatment were compared; and after 3 months the Glasgow Outcome Score (GOS) was evaluated. Results The levels of CytC in CSF were significantly lower on day 1, 3, and 7 in the mild hypothermia group than those in the control group [(36.2 ± 7.3) ng/L vs. (51.3 ± 8.1) ng/L, (44.5±10.1) ng/L vs. (69.3 ± 9.0) ng/L, and (34.8 ± 9.4) ng/L vs. (57.5 ± 8.0) ng/L, all P < 0.05] whereas caspase-3 levels in the CSF on day 1, 3, and 7 in the mild hypothermia group were significantly lower than those in the control group [ (98.5 ± 11.5) ng/L vs. (121.5 ± 11.8) ng/L, (109.7 ± 12.0) ng/L vs. (139.6 ± 11.8) ng/L, and (93.8 ± 9.5) ng/L vs. (117.9 ± 10.9) ng/L, all P < 0.05]. The ICP on day 1, 3, and 7 in the mild hypothermia group was significantly lower than those in the control group [(20.1 ± 3.5) mmHg vs. (25.5 ± 4.2) mmHg, (16.8 ± 3.2) mmHg vs. (22.8 ± 3.7) mmHg, and (14.9 ± 3.2) mmHg vs. (20.5 ± 3.4) mmHg, all P < 0.05]. After 3 months, the prognosis of the mild hypothermia group was significantly better than that of the control group (P < 0.05). Conclusion Mild hypothermia treatment can reduce the levels of CytC and caspase-3 in CSF, and improve the patients’ prognosis. Key words: Hypothermia; Traumatic Brain Injury; Apoptosis; Cerebrospinal Fluid