Neurological Disorders and Brain Injury

Background: Most patients with heavy traumatic brain injury (TBI) are nursed in ICUs. Clinical trials indicate significant mortality and morbidity in cases with sustained increases in intracranial pressure (ICP). A current way of controlling intracranial pressure in ICU is therapeutic hypothermia. The benefit of hypothermia on functional outcome is unclear. Methods: 26 patients were randomly enrolled in the experimental group and 26 patients in the control group. Patients in the experimental group (n=26) were subjected to therapeutic hypothermia and monitored by 24 hour-recording of temperature and intracranial pressure. In control group (n=26), 24 hours recording of body temperature ​​and intracranial pressure was also performed but without the use of therapeutic hypothermia. Patient recording ranged from 1 to 6 days. Results: There were 1638 hourly measurements of intracranial pressure in the control patient group. ICP exceeded ≥ 15 mmHg in 1192 of these hourly measurements while in remaining 446 values ranged from 8-14 mmHg. In experimental group, 2.208 hourly ICP measurements were performed. ICP values exceeded ≥15 mmHg in 685 and ranged from 5-14 mmHg in 1523 hourly measurements. The effect of therapeutic hypothermia was found significant (F=14.34, p=0.000). Conclusions: Our investigation showed that therapeutic hypothermia can be used as an additional form of treatment of intracranial hypertension although the benefit in secondary injuries when patient intracranial pressure was ≥ 20 mmHg remains unclear. In particular, in patients with ICP>20 mmHg after TBI, therapeutic hypothermia does not improve results than the traditional form of care.