Clinical research on the effects of hypothermia in patients with severe traumatic brain injury and acute traumatic coagulopathy

Objective To study the effect of hypothermia and its clinical significance in patients with severe traumatic brain injury (sTBI) and acute traumatic coagulopathy (ATC).Methods All 83 patients were randomly assigned into two groups:the hypothermia group consisted of 42 patients with hypothermia treatment and the control group consisted of 41 cases with routine treatments.Hypothermia was induced within 24 hours after brain injury.The levels of PT,APTT,TT,FIB,and D-dimer were measured.Meantime,intracranial pressure (ICP),vital signs,blood gas values,blood electrolytes,and arterial oxygen saturation were also measured.Prognosis was evaluated according to the Glasgow Outcome Scale (GOS).Results Compared to the control group,there were no significant differences between levels of PT,APTT,TT,FIB,and D-dimer (P ＞0.05) and ICP significantly decreased (P＜0.01) respectively in the hypothermia group.The vital signs,blood gas values,blood electrolytes,and arterial oxygen saturation were not significantly changed.No severe complications were found.The mortality was lower and GOS of the patients discharge was improved in the hypothermia group than that of the control group.Conclusions In patients with sTBI and ATC,hypothermia will not increase the risk of coagulopathy and hyperfibrinolysis; it can protect brain tissues through decreasing ICP,and it is a safe and effective therapy. Key words: Traumatic brain injury;  Acute traumatic coagulopathy;  Hypothermia