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低温疗法对创伤性脑损伤儿童的影响:一项随机对照试验的荟萃分析

Effect of Hypothermia Therapy on Children with Traumatic Brain Injury: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Du Qiujing, Liu Yuwei, Chen Xinrong, Li Ka

机构信息

West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Brain Sci. 2022 Jul 30;12(8):1009. doi: 10.3390/brainsci12081009.

Abstract

Hypothermia therapy is a promising therapeutic strategy for traumatic brain injury (TBI); however, some trials have shown that hypothermia therapy has a negative effect on patients with TBI. The treatment of hypothermia in children with TBI remains controversial. We conducted a search of six online databases to validate the literature on comparing hypothermia with normal therapy for children with TBI. Eight randomized controlled trials (514 patients) were included. The meta-analysis indicated that hypothermia therapy may increase the Glasgow Outcome Scale (GOS) scores. However, in terms of improving the rate of complications, intracranial pressure (ICP), mortality, cerebral perfusion pressure (CPP), and length of stay both in hospital as well as pediatric ICU, the difference was not statistically significant. Hypothermia therapy may have clinical advantages in improving the GOS scores in children with TBI compared with normothermic therapy, but hypothermia therapy may have no benefit in improving the incidence of complications, ICP, mortality, CPP, and length of stay both in pediatric ICU as well as hospital. The decision to implement hypothermia therapy for children with TBI depends on the advantages and disadvantages from many aspects and these must be considered comprehensively.

摘要

亚低温治疗是创伤性脑损伤(TBI)一种很有前景的治疗策略;然而,一些试验表明亚低温治疗对TBI患者有负面影响。TBI患儿的亚低温治疗仍存在争议。我们检索了六个在线数据库,以验证关于比较TBI患儿亚低温治疗与常规治疗的文献。纳入了八项随机对照试验(514例患者)。荟萃分析表明,亚低温治疗可能会提高格拉斯哥预后量表(GOS)评分。然而,在改善并发症发生率、颅内压(ICP)、死亡率、脑灌注压(CPP)以及住院时间和儿科重症监护病房(PICU)住院时间方面,差异无统计学意义。与常温治疗相比,亚低温治疗在改善TBI患儿GOS评分方面可能具有临床优势,但在改善PICU和医院的并发症发生率、ICP、死亡率、CPP以及住院时间方面可能并无益处。对TBI患儿实施亚低温治疗的决定取决于多方面的利弊,必须综合考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d16e/9406098/8547194b24c9/brainsci-12-01009-g001.jpg

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