Hypothermia Not Beneficial in Severe Meningitis
(HealthDay News) – For patients with severe bacterial meningitis, hypothermia does not improve outcomes and may be harmful, according to a study published online Oct. 8 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 5–9 in Paris.
Bruno Mourvillier, MD, from the Université Paris Diderot, and colleagues conducted a multicenter randomized trial involving 98 comatose adults with community-acquired bacterial meningitis to examine whether induced hypothermia improves outcomes.
The trial was stopped early due to concerns over excess mortality in the hypothermia group (51% of patients vs. 31% in the control group; relative risk, 1.99). The researchers found that there was an unfavorable outcome at three months in 86% of the hypothermia group, compared with 74% of controls (relative risk, 2.17; P=0.13). Mortality remained higher, although not significantly so, after adjustment for age, score on Glasgow Coma Scale at inclusion, and the presence of septic shock at inclusion (hazard ratio, 1.76; P=0.10). Similar results were seen for patients with pneumococcal meningitis.
"Our trial does not support the use of hypothermia in adults with severe meningitis," the authors write. "Careful evaluation of safety issues in these future and ongoing trials are needed."
The study was partially funded by IST Cardiology and Covidien.