Lowering the body temperature in people who have suffered a traumatic brain injury (TBI), as soon as possible after the trauma, may significantly improve chances of survival in adults, suggests research from Royal Holloway College, University of London.
Purposely lowering the body temperature, known as therapeutic hypothermia (TH), involves reducing the body temperature of a person to protect neurons from being killed off or damaged.
Professor Pankaj Sharma, Director of the Institute of Cardiovascular Research at Royal Holloway, said:
“Lowering the body temperature to treat people with TBI is a controversial treatment, but one that our latest research has shown to reduce deaths and long-term injury. We have undertaken the largest such analysis of data on the use of therapeutic hypothermia and have found that patients have an 18% better chance of surviving and a 35% improvement in neurological outcome if they are given this treatment.“
Traumatic Brain Injury Growing Concern
The World Health Organisation has predicted that traumatic brain injury will become a major cause of death and disability across the world. TBIs can be caused by many things, including car accidents, but most are caused by falls.
Currently there are around 5 million people in the US and 7.7 million people in Europe living with a TBI-related injury. Around 50% of those affected are unable to return to work, costing the economy $56 billion annually in the US alone.
American Football has recently come under the spotlight after research suggested that 40 percent of NFL players have suffered a TBI.
Not Indicated For Children
Researchers conducted a meta-analysis of around 3,100 cases of TBI in adults and around 450 cases in children. They found that cooling the brain to a temperature of 33c for 72 hours, and then allowing the patient to return to their normal temperature of 37c at their natural speed is the most effective treatment.
“Whilst cooling adults is effective at providing the best possible outcome, cooling children instead can prove fatal. In children between the ages of 3 months and 18 years, cooling provoked a 66% increase in mortality,” said Professor Sharma.
“This research has far-reaching implications in medicine, potentially affecting the treatment of millions of patients world-wide. We hope that the results of this study encourage medical practitioners to consider the use of this method to enable people who suffer these injuries to live fuller, longer lives.“
Ellie M. Crompton et al. Meta-Analysis of Therapeutic Hypothermia for Traumatic Brain Injury in Adult and Pediatric Patients Critical Care Medicine (2016). DOI: 10.1097/CCM.0000000000002205
Image: Royal Holloway, University of London