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| The effects of hypothermia on prognosis in severe traumatic brain injury patients: a systematic review |
| HE Haiyan1,2 HUANG Huaping2 KANG Xiuhua2 FU Jing1▲ |
1.College of Nursing, Southwestern Medical University, Sichuang Province, Luzhou 646000, China;
2.Intensive Care Unit of Mianyang Central Hospital, Sichuang Province, Mianyang 621000, China |
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Abstract Objective To explore the effects of hypothermia on prognosis in severe traumatic brain injury (sTBI) patients, and provide the best evidence to clinical practice. Methods The databases PubMed, the Cochrane library, clnicaltrials.gov and CNKI were systematically searched from their inception to June 2017 to identify relevant randomized controlled trials (RCTs). Two authors independently reviewed and extracted data from included studies. The outcome variables of the study were mortality and neurologic recovery. All data was analyzed by Review Manager version 5.3 and CMA version 3.0, TSA version 0.9 beta was applied to estimate whether the pooled outcome was conclusive. Results A total of 14 trials involving 2024 sTBI patients divided into subhypothermia treatment group and normal temperature treatment group were included in this study. The pooled results showed that there was no significant statistical difference in mortality between two groups (RR = 0.92, 95%CI=0.74-1.14, P = 0.43), and TSA indicated that the current available evidence was conclusive. However, patients receiving hypothermia therapy had better neurological outcome than those receiving normothermia therapy (RR=1.23, 95%CI=1.02-1.49, P = 0.03), and TSA indicated that more studies should be included to clarify this issue. Conclusion Hypothermia can improve long-term neurological recovery for sTBI patients, but which is not helpful to decrease the mortality. Based on the low overall quality of included articles, more high-quality studies are needed to verify these results.
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