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首页> 外文期刊>Archives of Neurology >The role of hypothermia in the management of severe brain injury: a meta-analysis.
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The role of hypothermia in the management of severe brain injury: a meta-analysis.

机译：体温过低的管理的作用严重的脑损伤:一个荟萃分析。

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CONTEXT: Hypothermia is utilized in the management of severe traumatic brain injury despite the lack of unequivocal evidence supporting its use. Because of its widespread use, the effects of hypothermia are a concern. OBJECTIVE: To determine the effectiveness of hypothermia in the management of severe brain injury. DATA SOURCES: Two investigators working independently abstracted data in a blinded fashion from studies identified using multiple literature databases, including MEDLINE, Ovid, PubMed, the Cochrane Database of Systematic Reviews, EMBASE, and the abstract center for the American Association of Neurological Surgery and the Congress of Neurological Surgery, as well as the bibliographies of these articles. Additionally, experts in the field of hypothermia and neurotrauma provided additional references. STUDY SELECTION: Seven studies met predetermined inclusion criteria: (1) the study was a randomized clinical trial comparing the efficacy of hypothermia vs normothermia in patients with posttraumatic head injury, (2) only subjects aged 10 years or older were included in the study, and (3) relative risks (odds ratios [ORs], cumulative incidence, or incidence density measures) and 95% confidence intervals (CIs) or weighted mean differences and 95% CIs could be calculated from the data presented in the article. These criteria were applied in a blinded fashion by 2 independent investigators. DATA EXTRACTION: No single outcome variable was evaluated in all studies. The following outcome variables were assessed: intracranial pressure, Glasgow Outcome Scale score, pneumonia, cardiac arrhythmia, prothrombin time, and partial thromboplastin time. Either ORs or weighted mean differences (when the data provided did not permit calculation of an OR) comparing the effects of hypothermia vs normothermia were calculated from the data provided. DATA SYNTHESIS: The weighted mean difference (hypothermia - normothermia) for intracranial pressure was -2.98 mm Hg (95% CI, -7.58 to 1.61; P =.2). The OR (hypothermia vs normothermia) for Glasgow Outcome Scale score was 0.61 (95% CI, 0.26-1.46; P =.3). The OR for pneumonia was 2.05 (95% CI, 0.79-5.32; P =.14). The OR for cardiac arrhythmia was 1.27 (95% CI, 0.38-4.25; P =.7). The weighted mean difference for prothrombin time was 0.02 seconds (95% CI, -0.07 to 0.10; P =.7). The weighted mean difference for partial thromboplastin time was 2.22 seconds (95% CI, 1.73-2.71; P<.001). CONCLUSIONS: This meta-analysis of randomized controlled trials suggests that hypothermia is not beneficial in the management of severe head injury. However, because hypothermia continues to be used to treat these injuries, additional studies are justified and urgently needed.
机译：背景:低体温是利用管理严重的创伤性脑损伤,尽管缺乏明确的证据支持它的使用。因为它的广泛使用,所造成的影响低体温是一个问题。确定了低体温症的有效性管理严重的脑损伤。两个调查人员独立工作从研究抽象数据盲评确定使用多个文献数据库,包括MEDLINE、奥维德、PubMed,科克伦数据库的系统评价、EMBASE,抽象的美国协会的中心神经外科手术和国会神经外科手术,以及这些文章的参考书目。体温过低和该领域的专家创伤提供额外的引用。选择:满足预定的7个研究入选标准:(1)研究随机临床试验比较疗效患者的体温过低与正常体温创伤后头部受伤,(2)科目10年以上包括在这项研究中,(3)相对风险(优势比(ORs),累积的发病率或发病率密度措施)和95%置信区间(CIs)或加权平均数差异和95%顺式可以计算本文提出的数据。被蒙蔽的方式应用2独立的调查。单变量是评估结果研究。评估:颅内压,格拉斯哥的结果量表得分、肺炎、心律失常,凝血酶原时间、部分血栓形成质时间。(当不允许提供的数据计算一个或)比较的影响体温过低与正常体温计算提供的数据。平均差(低体温正常体温)颅内压力是-2.98毫米汞柱(95%可信区间,-7.58 - 1.61;正常体温),格拉斯哥结果评分分数0.61 (95% CI, 0.26 - -1.46;肺炎是2.05 (95% CI, 0.79 - -5.32;心律失常的或者是1.27(95%可信区间,0.38 - -4.25;凝血酶原时间为0.02秒(95% CI,-0.07 - 0.10;差异部分血栓形成质次2.22秒(95% CI, 1.73 - -2.71;结论:随机的荟萃分析对照试验表明,体温过低不是有益的管理严重的头受伤。是用于治疗这些伤害,额外的研究是合理的和迫切需要。

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