Hypothermia Ineffective in Severe Childhood Brain Injury

June 4, 2008

Severely head-injured children who were treated with hypothermia post-injury fared worse than those who did not receive hypothermia treatment and had higher mortality rates, according to a research paper published June 5 in the New England Journal of Medicine.

WEDNESDAY, June 4 (HealthDay News) -- Severely head-injured children who were treated with hypothermia post-injury fared worse than those who did not receive hypothermia treatment and had higher mortality rates, according to a research paper published June 5 in the New England Journal of Medicine.

James Hutchison, M.D., of the Hospital for Sick Children in Toronto, Canada, and colleagues evaluated 225 children with severe traumatic brain injuries who were randomly placed into one of two groups: the first received hypothermia therapy (32.5 degrees Celsius for 24 hours, initiated within eight hours after injury), while the second did not (37 degrees C). Children's neurological abilities were assessed at six months using a six-point Pediatric Cerebral Performance Category scale.

At six months, 31 percent of the hypothermia patients had unfavorable outcomes, including a mortality rate of 21 percent, compared with a 12 percent mortality rate in the normothermia group, the investigators found. Children who received hypothermia therapy had more incidences of hypotension and also required more vasoactive agents while undergoing rewarming. While the neurological functioning of both groups improved after six months, those who did not receive hypothermia treatment improved slightly more. Differences in treatment did not appear to affect length of stay in the hospital or other adverse events.

"We conclude that the use of this hypothermia protocol is not warranted for the treatment of severe head injury in children," the authors write. "It is plausible that hypothermia therapy might be more effective if it were initiated earlier," but further research is needed.

One author reports a financial relationship with Johnson & Johnson.

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