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Use of hypothermia may be harmful for severe meningitis

Date:
October 8, 2013
Source:
American Medical Association (AMA)
Summary:
Treatment using hypothermia is sometimes used to improve the functional outcome of comatose patients with bacterial meningitis. However, new research is suggesting that this technique may be more harmful than the use of standard care.

Bruno Mourvillier, M.D., of the Universitι Paris Diderot, Sorbonne Paris Citι, Paris, and colleagues conducted a study to examine whether treatment with hypothermia would improve the functional outcome of comatose patients with bacterial meningitis compared with standard care.

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Among adults with bacterial meningitis, the death rate and frequency of neurologic complications are high, indicating the need for new therapeutic approaches. Clinical trials of patients with trauma who were treated with hypothermia have shown a decrease of intracranial pressure, suggesting a potential benefit of this technique in bacterial meningitis, according to background information in the article appearing in JAMA.

The randomized trial conducted in 49 intensive care units in France between February 2009 and November 2011 assessed 130 patients for eligibility and randomized 98 comatose adults with community acquired bacterial meningitis to the hypothermia group, where patients received a loading dose of 39°F cold saline and were cooled to 90°F to 93°F for 48 hours, or standard care.

The trial was stopped early because of concerns over excess mortality in the hypothermia group (25 of 49 patients [51 percent]) compared with the control group (15 of 49 patients [31 percent]). At 3 months, 86 percent in the hypothermia group compared with 74 percent in the control group had an unfavorable outcome (as gauged via the Glasgow Outcome Scale [a functional assessment inventory]).

"In conclusion, our trial does not support the use of hypothermia in adults with severe meningitis. Moderate hypothermia did not improve outcome in patients with severe bacterial meningitis and may even be harmful. Our results may have important implications for future trials on hypothermia in patients presenting with septic shock or stroke. Careful evaluation of safety issues in these future and ongoing trials are needed," the authors write.


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Bruno Mourvillier. Induced Hypothermia in Severe Bacterial Meningitis. JAMA, 2013; DOI: 10.1001/jama.2013.280506

Cite This Page:

American Medical Association (AMA). "Use of hypothermia may be harmful for severe meningitis." ScienceDaily. ScienceDaily, 8 October 2013. <www.sciencedaily.com/releases/2013/10/131008122445.htm>.
American Medical Association (AMA). (2013, October 8). Use of hypothermia may be harmful for severe meningitis. ScienceDaily. Retrieved November 25, 2014 from www.sciencedaily.com/releases/2013/10/131008122445.htm
American Medical Association (AMA). "Use of hypothermia may be harmful for severe meningitis." ScienceDaily. www.sciencedaily.com/releases/2013/10/131008122445.htm (accessed November 25, 2014).

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