Head injury (moderate to severe)

Head injury (moderate to severe)

New evidence; conclusion confirmed for:

Hyperventilation: One updated systematic review found no new evidence on the effects of hyperventilation. Categorisation unchanged (Unknown effectiveness).

Hypothermia (therapeutic): One systematic review updated. The review found no significant difference between hypothermia and normothermia in rates of mortality. The review found conflicting evidence on unfavourable outcomes (including death, vegetative state, or severe disability). In a meta-analysis of RCTs of any quality, the review found that hypothermia reduced the risk of unfavourable outcomes compared with normothermia. However, a subgroup analysis of high-quality RCTs found no significant difference between groups for unfavourable outcomes. Categorisation unchanged (Unknown effectiveness).

Anticonvulsants versus placebo: One updated systematic review identified no new evidence on the effects of barbiturates in the treatment of head injury. Categorisation unchanged (Unlikely to be beneficial).

Corticosteroids: One updated systematic review identified no new evidence on the effects of corticosteroids. Categorisation unchanged (Likely to be ineffective or harmful).

http://clinicalevidence.bmj.com/ceweb/conditions/nud/1210/1210.jsp?rss=true

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