SynthesisIntensive care medicine2003
Hypothermia in the management of traumatic brain injury. A systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Therapeutic hypothermia in patients with traumatic brain injury: an umbrella review.BMC neurology · 2025Pooled it
- A systematic review of therapeutic hypothermia for adult patients following traumatic brain injury.Critical care (London, England) · 2014Pooled it
- Management of bleeding and coagulopathy following major trauma: an updated European guideline.Critical care (London, England) · 2013Pooled it
- Management of bleeding following major trauma: an updated European guideline.Critical care (London, England) · 2010Guideline
- Management of bleeding following major trauma: a European guideline.Critical care (London, England) · 2007Guideline
- Hypothermia decreases cerebrospinal fluid asymmetric dimethylarginine levels in children with traumatic brain injury.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2013Trial
- Trial
- Under-humidification and over-humidification during moderate induced hypothermia with usual devices.Intensive care medicine · 2006Trial
- Clinical Insights and Future Directions in Hypothermia for Severe Traumatic Brain Injury: A Narrative Review.Journal of clinical medicine · 2024Review
- The 100 most-cited articles in hypothermic brain protection journals: a bibliometric and visualized analysis.Frontiers in neurology · 2024Article
- Accidental hypothermia as an independent risk factor of poor neurological outcome in older multiply injured patients with severe traumatic brain injury: a matched pair analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019Article
- Article
- Targeted temperature management in neurological intensive care unit.World journal of methodology · 2017Review
- Early detection of nonneurologic organ failure in patients with severe traumatic brain injury: Multiple organ dysfunction score or sequential organ failure assessment?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2016Article
- Hypothermia for Increased Intracranial Pressure: Is It Dead?Current neurology and neuroscience reports · 2016Review
- Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury.World journal of critical care medicine · 2015Article
- The use of targeted temperature management for elevated intracranial pressure.Current neurology and neuroscience reports · 2014Review
- Therapeutic Hypothermia in Children and Adults with Severe Traumatic Brain Injury.Therapeutic hypothermia and temperature management · 2014Review
- Therapeutic hypothermia for traumatic brain injury.Current neurology and neuroscience reports · 2012Review
- Facts and fiction: the impact of hypothermia on molecular mechanisms following major challenge.Mediators of inflammation · 2012Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveBrain injury remains the leading cause of death in cases of trauma in North America and Europe. This article critically appraised and summarised all published and peer-reviewed, randomised, controlled trials of the use of hypothermia in traumatic brain injury.
designTo be included, a study had to be a published, randomised, controlled trial of the use of hypothermia in the management of traumatic brain injury. Pooling of data and meta-analysis of results occurred.
settingConducted at a tertiary level Canadian teaching hospital. PATIENTS AND
participantsPatients were combined from eight randomised, controlled trials to generate a population of 748 severely head-injured patients. MEASUREMENTS AND
resultsEight studies provided data on the efficacy of hypothermia in the management of traumatic brain injury. The pooled odds ratio of mortality in the hypothermic group was 0.81 (95%CI =0.59-1.13, p=0.22). The OR of a poor neurological outcome (GOS 1,2 or 3) was 0.75 (95% CI=0.56-1.01, p=0.06). The odds ratio for pneumonia in the normothermic group was 0.42 (95%CI =0.25-0.70, p=0.001).
conclusionsAlthough meta-analysis suggests that iatrogenic hypothermia may confer a marginal benefit in neurological outcome, there does not appear to be clear evidence of lower mortality rates in unselected traumatic brain injury patients. Prolonged hypothermia may confer a benefit, particularly in patients with elevated intracranial pressure refractory to conventional manipulations. Conclusions regarding the use of hypothermia are controversial and not strongly supported by the available evidence.
Indexed as
Identifiers
12915937What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.