No Benefit, More Complications with Hypothermia after Traumatic Brain Injury

MedicalResearch.com Interview with:

Jamie Cooper AO BMBS MD FRACP FCICM FAHMS Professor of Intensive Care Medicine Monash University Deputy Director & Head of Research,  Intensive Care & Hyperbaric Medicine The Alfred, Melbourne

Prof. Cooper

Jamie Cooper AO
BMBS MD FRACP FCICM FAHMS
Professor of Intensive Care Medicine
Monash University
Deputy Director & Head of Research,
Intensive Care & Hyperbaric Medicine
The Alfred, Melbourne

MedicalResearch.com: What is the background for this study?

Response: 50-60 million people each year suffer a traumatic brain injury (TBI) . When the injury is severe only one half are able to live independently afterwards.

Cooling the brain (hypothermia) is often used in intensive care units for decades to  decrease inflammation and brain swelling and hopefully to improve outcomes, but clinical staff have had uncertainty whether benefits outweigh complications.

We conducted the largest randomised trial of hypothermia in TBI, in 500 patients, in 6 countries, called POLAR. We started cooling by ambulance staff, to give hypothermia the best chance to benefit patients. We continued for 3-7 days in hospital ind ICU. We measured functional outcomes at 6 months.

MedicalResearch.com: What are the main findings?

Response: We found that carefully measured outcomes after severe TBI were exactly the same at 49% independent outcomes in both study groups. Remarkably, hypothermia had no measurable effect on patients functional outcome at all.  Hypothermia did however increase complications of low blood pressure, and pneumonia.

MedicalResearch.com: What should readers take away from your report?

Response: Even when hypothermia is used in such a way as to maximinse benefits and decrease complications, it does not benefit patients after a severe TBI. It also requires expensive cooling devices, longer intensive  care time and increases complications.

The best target temperature for trauma patients during the week after severe TBI is now the normal one, not the cool one. Clinical guidelines should be adjusted accordingly

POLAR was funded by the Australian government through the NHMRC, and also the Victorian State Government via the TAC. No other relevant disclosures. No industry support. POLAR was managed by the ANZIC Research Centre at Monash University, Melbourne Australia, and endorsed by the ANZICS Clinical Trials Group.
 

Citation:

Cooper DJ, Nichol AD, Bailey M, et al. Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain InjuryThe POLAR Randomized Clinical TrialJAMA.Published online October 24, 2018. doi:10.1001/jama.2018.17075

Oct 25, 2018 @ 11:17 am 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.