Details of HTA project in progress
Last updated: 16 March 2010 - Next update due: 23 March 2010
Research type: |
Secondary Research (e.g. systematic review) |
Project title: |
Systematic review of head cooling in adults after traumatic brain injury and stroke |
Project ref: |
07/37/32 |
Cost: |
£67,933 |
Chief Investigator : |
Ms Bridget Harris, Research Fellow, Clinical and Surgical Sciences, University of Edinburgh |
Start Date: |
May 2009 |
Publication date: |
Early 2012. This date takes account of time for report preparation and printing based on current average times for these activities. |
Plain English Summary |
A raised temperature is common and damaging to the brain after brain injury and stroke, therefore patients may be cooled to reduce temperature and thereby reduce brain damage. If the brain sustains less damage more people should survive with fewer disabilities. The cooling methods used can be grouped into those targeted at the whole body (systemic methods) and those targeted at the head (head cooling methods). Head cooling has theoretical advantages over systemic methods because it is directed at the brain which is where cooling is needed. We intend to review the research evidence on head cooling in brain injury and stroke. We will undertake a thorough search of a variety of databases and literature to find research on head cooling. Using the good quality research we will assess whether head cooling can reduce brain temperature and whether it results in less disability and fewer deaths. We will also assess whether head cooling affects certain other indicators of brain damage, such as brain pressure, whether there are side effects and how effectively temperature is reduced. Studies of head cooling in conditions other than brain injury and stroke may be included if they contribute information on how effectively the methods reduce temperature, their ease of use and side effects. Brain injury and stroke are costly in human and resource terms and we will evaluate whether head cooling has economic benefits in the management of traumatic brain injury and stroke. Our multidisciplinary team is well placed to carry out this review. It includes a nurse researcher and a Professor of Intensive Care who have experience in head cooling and care of acutely ill patients after stroke and brain injury, a Professor of Medical Statistics with a special interest in brain injury and stroke, and a Health Economist experienced in evaluating economic benefits of health care interventions. We have support from the locally based Cochrane Stroke Group which specialises in the type of evidence review we are intending to do. |
Project Abstract: |
The overall aim of this systematic review is to assess the effectiveness of non-invasive head cooling in reducing temperature and improving outcome in adults after traumatic brain injury and stroke. In order to achieve this, studies of head cooling will be systematically searched for and reviewed: Firstly, to address the explanatory, mechanistic question of what the cooling interventions achieve in terms of reducing brain temperature (or core trunk temperature as proxy). If there is a clear effect, then the characteristics of the intervention and/or patients associated with the extent of brain cooling will be explored. This objective will be informed by studies in cardiac arrest as well as those in stroke and traumatic brain injury. Secondly, to address the pragmatic, clinical question of what impact brain cooling has on patient outcomes (mortality and disability). Only the studies in stroke and traumatic brain injury will be relevant here, although studies in cardiac arrest may highlight some potential adverse effects of cooling. Thirdly, the cost effectiveness of head cooling in traumatic brain injury and stroke will be assessed. Fourthly, the results of the review will be presented to members of the general public in order to hear their views on the concept and possible use and effectiveness of head cooling. Ideally this will establish whether and to what extent head cooling is effective, in both brain injury and stroke, and which methods are most suitable in which circumstances. However, the degree to which this can be established depends on the nature and quality of the research available. Nevertheless, a comprehensive picture of head cooling research will be generated which can inform clinicians and guide researchers, and which can be updated as further studies become available. |
Project Protocol: |
Project protocol not available |
URL of this page: |
http://www.hta.ac.uk/1777 |
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