Abstract
We examined whethar maintained cardiac output has benefical effect on neurological outcome evaluated about 6 months after traumatic brain injury (TBI) treated in moderate hypothermia of 32-33°C. Consecutive thirty one TBI patients were selected as a hypothermia group and serial 13 patients treated in 36.5-38°C were thought of as a control group. All patients had Glasgaw Coma Scale (GCS) less than or equal to 8 on admission and positive findings on CT scan. The hypothermia period was ususally three to four days and then patients were rewarmed at a rate of 1°C per day. There was no difference in age, gender, GCS score on admission and other indices between the groups. Cardiac output in hypothermic group was intentionally maintained in normal-hyperdynamic range by fluid loading and low dose dobutamine. The rate of the good outcome (GR, good recoverry+MD; moderate disability in GOS) was, however, significantly higher in hypothermic group than that of normothermic group (22/31 vs. 4/13; Chi-Square test, p<0.05). Although the effect of hypothermic therapy remains controversial, we insist that moderate hypothermia improves neurological outcome of TBI patients so far as their cardiac output was maintained in normal-hyperdynamic range.
