|
Question |
Deliberate hypothermia after OOHVFA |
|
Type |
· Multi-centre, partially-blinded RCT |
|
Groups |
· 32-34°C vs normothermia for 24 hours |
|
Upshot |
· ↓Mortality in hypothermic group |
|
Comments |
· Control group became hyperthermic · Did cold group do better because cold, or because not hot? |
|
Question |
Coiling vs clipping for SAH |
|
Type |
· Multi-national RCT |
|
Upshot (coiling) |
· ↓Mortality at 1 year · ↑Further bleeding but still unlikely |
|
Question |
IV corticosteroid in TBI |
|
Type |
· Multi-national, placebo-controlled RCT |
|
Upshot |
· ↑2/52 mortality · ↑6/12 mortality |
|
Question |
Deliberate intra-op hypothermia (33C) for intracranial aneurysm surgery |
|
Type |
· Multi-centre, partially blinded RCT |
|
Groups |
· 33°C vs 36.5°C |
|
Upshot (cold) |
· ↑Post-op bacteraemia · ↔Neuro outcome |
|
Question |
Triple H therapy in SAH |
|
Upshot |
· Evidence for hypertension · No evidence for hypervolaemia or haemodilution |
|
Question |
Decompressive craniectomy in TBI |
|
Type |
· Multi-centre RCT |
|
Upshot |
· ↓ICP · ↓ICU length of stay · ↑Unfavourable outcome |
|
Question |
Deliberate hypothermia after TBI in paeds |
|
Upshot |
· Terminated early because waste of time |
|
Question |
Deliberate hypothermia after cardiac arrest |
|
Type |
· Multi-national RCT |
|
Groups |
· 33°C vs 36°C |
|
Upshot |
· Constant temp preferable · No evidence for benefit of cooling |
|
Question |
Decompressive craniectomy for traumatic intracranial hypertension |
|
Type |
· Multi-national RCT |
|
Upshot |
· ↓Mortality · ↑Severe disability |
|
Question |
Deliberate hypothermia after blunt TBI |
|
Type |
· Multi-national, partially blinded RCT |
|
Groups |
· 33°C vs 37°C |
|
Upshot |
· ↔Neuro outcome at 6 months · ↔ICP · ↑Pneumonia · ↑Ventilation days · ↑Bradycardia · ↑Noradrenaline use · Comment: lays to rest the question of therapeutic hypothermia |
|
Question |
TXA in TBI |
|
Type |
Multi-national, double-blinded placebo-controlled RCT |
|
Upshot |
↔Mortality ↓Head injury-associated death if within 3 hours |
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