Prophylactic hypothermia for severe Traumatic Brain Injury: POLAR RCT

Cooper J, Nichol A:JAMA October 2018 online first

Clinical Question

-  In patients with severe blunt traumatic brain injury (TBI) does early and sustained cooling compared with standard care improve neurological outcomes at 6 months?

N = 400, 14 institutes in 6 countries

Authors’ Conclusions

-  There is absolutely no sign in this trial that early and sustained prophylactic hypothermia improves neurological outcome
-  This trial puts hypothermia to bed!

The Bottom Line

-  I will aim for normothermia in my patients with TBI
-  Significantly: hypothermia did not improve 6 month outcome, but increased pneumonia, ventilation days, bradycardia and noradrenaline use
-  Hypothermia did not reduce ICP