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Effect of therapeutic hypothermia on the incidence and treatment of intracranial hypertension.

Therapeutic hypothermia initiated immediately after a severe head trauma holds promise for improving outcomes. However, the effect of hypothermia on intracranial pressure (ICP) is not yet known. This study was a secondary analysis, conducted within a National Institutes of Health clinical trial on the efficacy of therapeutic hypothermia, to determine the effects of therapeutic hypothermia on ICP and of interventions (i.e., cerebrospinal fluid drainage and mannitol administration) on intracranial hypertension. There were no significant differences in the overall incidence or treatment of intracranial hypertension between patients who were treated with therapeutic hypothermia and normal controls. Therapeutic hypothermia maintained the ICP at lower levels during the cooling phase, but once patients were rewarmed, the ICP elevated to the levels of normothermic patients.