Hypothermia, Induced

A total of 120 patients with STBI, who were treated in our hospital from February 2019 to April 2021, were selected in the present study. The patients were randomly divided into control and experimental groups. The control group accepted mild hypothermia therapy. The experimental group accepted targeted temperature management and mild hypothermia therapy. In the control group, the age ranged from 37 to 67 years old with an average of 45.91 ± 3.53 years, including 34 males and 26 females. The GCS score was 3 to 7 with an average of (5.13 ± 1.31). Types of injury included 8 cases of intracranial hematoma, 45 cases of brain contusion and laceration and 7 cases of other injuries. The time from injury to admission was 1 to 3.1 hour with an average of 2.12 ± 0.22 hours. In the experimental group, the age ranged from 35 to 70 years old with an average age of 42.75 ± 3.53 years. The experimental group included 31 males and 29 females with a GCS score of 3 to 7 and an average of 5.53 ± 1.42 points. The type of injury included 10 cases of intracranial hematoma, 43 cases of brain contusion and laceration and 7 cases of others. The time from injury to admission was 1 to 3.5 hours with an average of 2.53 ± 0.21 hours. There exhibited no statistical significance in the general data. This study was permitted by the medical ethics association of our hospital and all patients signed informed consent.
Inclusion criteria: All patients were admitted to hospital within 12 hours after injury; The diagnosis was confirmed by head computerized tomography or magnetic resonance imaging scan and there was no serious combined injury of other organs; No cerebral hemorrhage, cerebral infarction and traumatic brain injury, no major diseases of cardiopulmonary system, liver and kidney system and hematopoietic system were found in the past; There was no history of infection before injury; According to the GCS coma scoring method: 3 ≤ GCS < 8.
Exclusion criteria: Severe combined injury or organ injury, which was life-threatening; GCS limb motor score = 6, or unable to assess consciousness with severe alcoholism; Complicated with severe systemic diseases, such as severe heart disease, hepatorenal insufficiency; Systolic blood pressure < 90 mm Hg or blood oxygen saturation < 93% after resuscitation; Platelet count < 50000/mm³; and Pregnant or lactating women.

The control group received mild hypothermia treatment. Nourishment of cerebral nerves, acid suppression and rehydration and reduction of intracranial pressure and antiinfection were given. All patients received mild hypothermia treatment within 12 hours after injury or surgery. The body uses cooling blanket and head ice cap to cool down, and the hibernation mixture uses chlorpromazine 100mg + promethazine 100mg + atraconine 200mg + normal saline 500mL intravenous drip to control the temperature at 32°C to 35°C (the whole-body temperature). Whether to add other physical cooling measures such as placing ice bags in armpits according to the cooling effect. After hypothermia treatment, the patient’s response to stinging pain became remarkably slower, pupils dilated and gradually narrowed, response to light became slower, respiratory rate lessened, deep reflexes were weakened or disappeared, and mild hypothermia was maintained for 5 days. During the treatment of mild hypothermia, the patient’s vital signs, heart rhythm, electrolytes, coagulation function and bleeding should be observed. If chills occur, diazepam, chlorpromazine or magnesium sulfate can be given for intravenous drip.
The experimental group received targeted temperature management and mild hypothermia therapy, mild hypothermia therapy was the same as the control group. The targeted temperature management was that ice blanket and mild hypothermia therapy apparatus were used to cool the whole body, micro pump into hibernation mixture, pump speed 6 mL/hour. The whole-body temperature of the patients was controlled at 32°C to 35°C for 5 days. After 5 days, the patient underwent natural rewarming method. The hibernating mixture, ice blanket and mild hypothermia therapeutic apparatus were stopped in turn. The natural rewarming time was 24 hours.