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June 11, 2003

Therapeutic Hypothermia for Severe Traumatic Brain Injury

Author Affiliations

Author Affiliations: Safar Center for Resuscitation Research, Department of Critical Care Medicine (Dr Kochanek) and Department of Anesthesiology (Dr Safar), University of Pittsburgh School of Medicine, Pittsburgh, Pa.

JAMA. 2003;289(22):3007-3009. doi:10.1001/jama.289.22.3007

Hypothermia has been recommended in the treatment of severe traumatic brain injury (TBI) since at least the 1800s.17 By the mid 1960s, moderate hypothermia (28°C-32°C) had become part of the routine treatment of patients with severe TBI in a number of centers worldwide.8 However, by the early 1980s, moderate hypothermia for TBI had fallen out of favor because of infectious complications associated with its prolonged and uncontrolled use.9 In contrast, hypothermia has remained an accepted treatment for refractory intracranial hypertension in both adults and children.10 In the 1990s, there was renewed interest in the application of mild (33°C-36°C) hypothermia in experimental incomplete cerebral ischemia and cardiac arrest.1114 A favorable effect of hypothermia has been reported in more than 90% of the 40 reports published by numerous laboratories using experimental models of TBI.

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