Mild hypothermia therapy plus edaravone improves neurological outcomes in patients with severe traumatic brain injury

Abstract

Objective To observe the treatment effect of edaravone plus mild hypothermia treatment on patients with acute severe traumatic brain injury (TBI).Methods One hundred and forty-three patients with TBI,admitted to our hospital from February 2008 to September 2012,were randomly divided into 4 groups:control group (group A,routine treatment,n=35),mild hypothermia treatment group (group B,routine treatment plus temperature control at the range of33～34 ℃ for 2-14 days,n=36),edaravone treatment group (group C,routine treatment plus edaravone up to 14 days,30 mg per time,twice per day,n=36) and mild hypothermia plus edaravone treatment group (group D,routine treatment combined with mild hypothermia plus edaravone n=36).Intracranial pressure (ICP) and arterial blood glucose were determined at admission,and 24 and 72 h after admission; Glasgow Outcome Scale (GOS) scores were assessed 3 months after the treatment.Results At 24 and 72 h after admission,the mean ICP of group B and group C was significantly lower than that of group A (P＜0.05); that of group D was significantly lower than that of group B and group C (P＜0.05).The mean blood glucose of group B and group C was obviously lower than that of group A (P＜0.05); group D was obviously lower than group B and group C (P＜0.05).The rate of good neurologic function (GOS scores 4-5) in group D was better than that of group B and group C (P＜0.05),which was significantly better than that of group A (P＜0.05).Conclusion It is much more effective to use mild hypothermia plus edaravone treatment than simple mild hypothermia or edaravone treatment in the early treatment of acute severe TBI. Key words: Traumatic brain injury; Mild hypothermia; Edaravone