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[(in)15.9(ju)22.2(ry)17.3(,)-293.8(a)0(n)17.5(d)-296.7(at)-283.7(a)-299.1(h)13.1(ig)22.2(he)17.5(r)-299.3(I)0(C)18.9(P)-295.3(th)22.2(re)21.2(sh)18.8(ol)15.9(d)-290.4(\()0(2)17.3(5)-157.6(mm)-284.3(Hg)16.6(\).)-283.2(In)-286.2(RE)21.7(SC)16.6(UE)16.8(ic)19.8(p)13.1(,)]TJ
0 -1.2266 TD
[(ei)13.5(t)15.4(h)0(e)17.5(r)-362.5(bi)15.9(-f)21.1(ro)17.3(n)13.1(t)0(o)22.2(-)0(t)19.6(e)0(m)14(p)13.1(or)17.3(al)-353.2(o)13.1(r)-368.8(u)13.1(n)0(i)22.2(l)0(a)13.5(t)15.4(er)14.9(al)-353.2(cr)21.2(an)17.5(ie)19.8(ct)19.8(om)16.4(y)-359.9(w)0(a)14.2(s)-361.1(pe)17.5(rm)20.1(it)18.2(te)19.8(d)13.1(,)]TJ
0 -1.2203 TD
[(wh)16.6(er)21.2(ea)15.1(s)-241(i)0(n)-230.7(D)0(E)16.8(C)0(R)23.2(A)-243.1(al)19.8(l)-243.8(p)0(a)17.5(t)0(i)18.2(e)0(n)23.9(t)0(s)-231.9(w)0(i)18.9(t)0(h)-230.7(c)0(r)14.9(a)0(n)17.5(i)15.4(ec)15.1(to)22.3(my)-230.2(ha)17.5(d)-239.8(d)0(i)15.9(f)0(f)21.1(u)0(s)18.8(e)-242.2(in)22.3(ju)15.9(ry)]TJ
T*
[(an)17.5(d)-663.4(r)0(e)14.9(c)0(e)21.4(i)0(v)22.2(e)0(d)-659(a)-665.8(b)13.1(i)0(-)19.6(f)0(r)21.1(o)0(n)19.9(t)0(o)15.9(-)0(t)19.6(e)0(m)20.3(p)13.1(or)17.3(o-)17.3(p)13.1(a)0(r)14.9(i)15.4(et)13.5(al)-650.4(pr)17.3(o)13.1(c)0(e)15.1(d)13.1(ur)17.3(e.)-656.1(In)-652.9(RE)21.7(S-)]TJ
T*
[(CU)18.2(Ei)16.1(cp)17.5(,)-357(p)13.1(at)19.8(ie)13.5(n)13.1(t)0(s)-352(h)13.1(ad)-349.2(in)15.9(tr)19.6(ac)21.4(ra)14.9(n)13.1(i)0(a)19.8(l)-357.6(hy)19.9(pe)17.5(rt)19.6(en)17.5(si)21.1(on)-353.1(re)21.2(fr)21.1(ac)15.1(to)22.2(ry)-349.4(to)-350.8(u)13.1(s)0(u)18.8(a)0(l)]TJ
0 -1.2266 TD
[(th)15.9(er)21.2(ap)17.5(ie)19.8(s)-399(\()0(i)13.3(n)13.1(cl)19.8(ud)19.9(in)22.2(g)-404.2(h)0(y)19.9(p)0(o)19.9(t)0(h)22.2(e)0(r)14.9(m)0(i)18.7(a)0(\))-389.7(u)0(p)-391(t)0(o)-395.1(1)13.1(0)-404.2(d)13.1(ay)17.5(s)-399(a)0(f)14.9(t)0(e)19.8(r)-400.5(ad)17.5(mi)18.7(ss)23.9(io)15.9(n)13.1(,)]TJ
0 -1.2203 TD
[(wh)16.6(er)21.2(ea)15.1(s)-215.7(i)0(n)-205.4(D)0(E)23.2(C)0(R)16.8(A)-217.8(p)13.1(a)0(t)19.8(i)0(e)19.8(n)0(t)15.9(s)-215.7(we)20.5(re)-206.4(ra)21.2(nd)19.9(om)16.4(iz)19.8(ed)-203.8(du)19.9(ri)19.6(ng)-207.7(th)22.2(ei)19.8(r)-217.1()0(r)18.8(s)0(t)-206.6(7)13.1(2)-157.6(h)13.1(.)]TJ
T*
[(Bo)15.2(th)-256(t)15.4(r)0(i)19.6(a)0(l)13.5(s)-259.9(pe)17.5(rm)20.1(it)18.2(te)19.8(d)-265.1(l)0(a)19.8(t)0(e)-258.4(d)13.1(ec)15.1(o)13.1(m)0(p)16.4(r)0(e)21.2(s)0(s)17.6(i)0(v)22.3(e)-267.5(cr)21.2(an)17.5(ie)19.8(ct)19.8(om)16.4(y)-265.1(i)0(n)-256(t)0(h)22.3(e)-267.5(co)23.9(nt)15.9(ro)23.7(l)]TJ
0 -1.2266 TD
[(gr)17.3(o)13.1(u)0(p)-397.4(a)0(s)-394.6(a)-406.6(li)18.2(fe)21.2(-s)22.5(av)17.5(in)15.9(g)-404.2(m)0(e)20.3(a)0(s)22.7(u)0(r)17.3(e)-406.6(an)23.9(d)-404.2(t)0(h)15.9(i)0(s)-396.2()67.4(c)21.2(ro)17.3(ss)17.6(o)13.1(v)0(e)17.5(r)0()78()-406.8(o)13.1(c)0(c)15.1(u)13.1(rr)14.7(ed)-393.5(in)]TJ
0 -1.2203 TD
[(37)19.9(.2)16.5(%)-204(o)13.1(f)-204.4(s)0(t)21.1(a)0(n)17.5(d)0(a)17.5(r)0(d)-191.3(c)0(a)15.1(r)0(e)-193.7(p)13.1(at)19.8(ie)13.5(n)13.1(t)0(s)-193.9(i)0(n)-192.7(R)0(E)15.4(S)14.6(CU)18.2(Ei)16.1(cp)23.9(,)-205.2(c)0(o)17.5(m)0(p)22.7(a)0(r)14.9(e)0(d)-191.1(w)0(i)18.9(t)0(h)-192.7(1)0(8)19.9(%)]TJ
T*
[(in)-287.6(DE)16.8(CR)16.8(A.)-283.9(In)-286.2(RE)15.4(S)14.6(C)0(U)18.2(E)0(i)16.1(c)0(p)17.5(,)-293.8(at)-290(6)-296.7(m)0(o)22.7(n)0(t)22.2(h)0(s)-291.1(m)0(o)22.7(r)0(t)19.6(a)0(l)19.8(i)0(t)18.2(y)-296.7(wa)20.5(s)-297.9(l)0(o)15.9(w)0(e)20.5(r)-299.3(af)21.3(te)19.8(r)]TJ
0 -1.2266 TD
[(cr)14.9(an)23.9(ie)13.5(ct)19.8(o)13.1(m)0(y)-249.1(\()0(2)23.7(6)0(.)16.5(9)13.1(%\))-244(th)15.9(an)-241.7(in)-249.6(st)21.1(an)17.5(d)13.1(a)0(r)21.2(d)-258.8(ca)21.4(re)-250.6(p)13.1(a)0(t)19.8(i)0(e)19.8(n)0(t)15.9(s)0(,)-243.9(w)0(h)23(o)-258.7(h)13.1(a)0(d)-248(a)-254.8(h)13.1(i)0(g)15.9(h)]TJ
0 -1.2203 TD
[(mo)16.4(rt)19.6(al)19.8(it)18.2(y)-429.5(r)0(a)21.2(t)0(e)-422.8(\()0(4)17.3(8)13.1(.5)16.5(%)-425.3(c)0(o)17.5(m)0(p)16.4(a)0(r)21.2(e)0(d)-418.8(w)0(i)18.9(t)0(h)-420.4(1)0(9)19.9(%)-431.6(in)-420.4(DE)16.8(C)14.7(R)0(A)18.2(\))0(.)]TJ
6.7246 0 0 5.9768 266.7401 269.4614 Tm
(12)Tj
8.9663 0 0 8.9663 277.285 265.4929 Tm
[(At)-417.3(12)]TJ
-24.261 -1.2203 TD
[(mo)16.4(n)13.1(t)0(h)15.9(s)0(,)-168(t)15.4(he)-172.2(p)13.1(r)0(o)17.3(p)13.1(or)17.3(ti)18.2(o)13.1(n)-176.5(of)-166(pa)17.5(ti)18.2(en)23.9(ts)-168.6(in)-167.4(RE)15.4(S)14.6(C)0(U)18.2(E)0(i)16.1(c)0(p)-165.8(w)0(i)18.9(t)0(h)-167.4(a)0(t)-163.5(l)0(e)13.5(a)0(s)22.7(t)-180.6(p)13.1(a)0(r)21.3(t)0(i)18.2(a)0(l)]TJ
T*
[(in)15.9(d)13.1(e)0(p)17.5(e)0(n)17.5(d)13.1(en)17.5(ce)-193.5(\(G)20.4(la)19.8(sg)18.8(ow)-192(Ou)16.6(tc)19.8(o)13.1(m)0(e)-194.7(S)0(c)18.9(a)0(l)19.8(e)0(-)14.9(E)13.3(xt)15.9(en)23.9(de)17.5(d)-201.8([)0(G)20.4(O)0(S)18.1(-)0(E)17.5(])-204.4(sc)22.7(or)17.3(e)-204.3(o)13.1(f)]TJ
0 -1.2266 TD
[(4)-290.4(o)0(r)-279.8(b)13.1(et)19.8(te)13.5(r,)-276.9(an)17.5(d)-284(t)0(e)19.8(r)0(m)13.8(e)0(d)]TJ
/F5 1 Tf
9.4148 0 TD
[(fa)15.9(vo)17.5(ra)25.1(bl)15.9(e)]TJ
/F4 1 Tf
4.053 0 TD
[(ou)19.9(tc)19.8(om)16.4(e)-286.5(i)0(n)-281.3(t)0(h)22.2(i)0(s)-282.4(t)0(r)19.6(i)0(a)19.8(l)0(\))-277.5(w)0(a)20.6(s)-291.6(g)13.1(r)0(e)14.9(a)0(t)19.8(e)0(r)]TJ
-13.4678 -1.2203 TD
[(th)15.9(an)-248(in)-256(co)23.9(nt)15.9(ro)23.7(ls)14.7(,)-255.8(b)0(u)19.9(t)-262.8(th)22.2(e)-261.2(p)0(r)17.3(o)0(p)19.9(o)0(r)17.3(t)0(i)24.6(o)0(n)19.9(s)-266.3(o)13.1(f)-261.4(pa)17.5(ti)18.2(en)23.9(ts)-250.8(in)-256(a)-261.2(v)13.1(eg)17.5(et)19.8(at)19.8(iv)15.9(e)-261.2(s)0(t)21.1(a)0(t)19.8(e)]TJ
T*
[(an)17.5(d)-303(a)0(l)19.8(l)-300.7(pa)17.5(ti)18.2(en)17.5(ts)-288.8(wi)18.9(th)-293.9(se)16.3(v)13.1(e)0(r)14.9(e)-299.1(di)15.9(sa)22.7(bi)15.9(li)24.5(ty)-293.9(we)14.2(re)-288.6(al)13.5(so)-291.1(in)22.2(cr)14.9(ea)21.4(se)16.3(d)13.1(.)-306.4(P)14.6(a)0(t)19.8(i)0(e)13.5(n)13.1(ts)]TJ
0 -1.2267 TD
[(wi)18.9(th)]TJ
/F5 1 Tf
1.9664 0 TD
[(se)16.3(ve)21.4(re)-205(di)15.9(sa)25.1(bi)15.9(li)18.2(t)15.4(y)]TJ
/F4 1 Tf
6.5885 0 TD
[(in)22.2(cl)13.5(u)13.1(d)0(e)-203.8(t)0(h)22.2(o)0(s)18.8(e)-216.9(wi)18.9(th)-205.4(l)15.4(o)0(w)16.6(e)0(r)-206.4(s)0(e)22.7(v)0(e)17.5(r)0(e)-206.4(\()0(d)23.7(e)0(p)17.5(e)0(n)17.5(d)13.1(en)17.5(t)-212.2(o)0(n)]TJ
-8.5549 -1.2203 TD
[(ot)15.9(h)13.1(e)0(r)14.9(s)-272.6(an)17.5(d)-271.4(c)0(a)15.1(n)13.1(no)19.9(t)-275.4(b)13.1(e)-273.8(l)0(e)13.5(f)0(t)-264.9(a)0(l)19.8(o)13.1(ne)-267(fo)23.7(r)-280.3(m)15.9(or)17.3(e)-273.8(t)0(h)15.9(a)0(n)-260.7(8)-157.6(h\))-267.2(an)23.9(d)-277.7(u)13.1(pp)19.9(er)-269.6(se)22.7(ve)17.5(re)]TJ
T*
[(di)15.9(sa)22.7(bi)15.9(li)18.2(t)15.4(y)-201.8(\(c)21.2(an)-184.8(be)-191.1(l)15.4(e)0(f)14.9(t)-193.2(al)13.5(o)13.1(n)13.1(e)-197.9(in)-186.4(th)15.9(e)-197.9(h)13.1(om)16.4(e)-191.6(f)0(o)17.3(r)-198.1(mo)22.7(re)-187.4(th)15.9(an)-184.8(8)-157.6(h)13.1(,)-198.9(b)13.1(ut)-186.4(ar)14.9(e)-191.6(n)0(o)19.9(t)]TJ
0 -1.2266 TD
[(in)15.9(d)13.1(e)0(p)17.5(e)0(n)17.5(d)13.1(en)17.5(t)-269.1(o)0(u)19.9(t)0(s)21.1(i)0(d)15.9(e)-267.5(th)15.9(e)-267.5(h)0(o)19.9(m)0(e)-264.2(a)0(n)23.9(d)-271.4(ca)15.1(n)13.1(n)0(o)19.9(t)-269.1(sh)18.8(op)19.9(\).)]TJ
6.7246 0 0 5.9768 231.307 170.8724 Tm
[(1,)25(15)]TJ
8.9663 0 0 8.9663 69.7323 155.9055 Tm
[(The)-373.8(12-month)-379.3(outcomes)-376.4(from)-373.5(the)-378(DECRA)-373.8(trial)-375(are)-379(presented)]TJ
-1.1128 -1.2203 TD
[(here)-271(and)-272.8(are)-271.5(considered)-269.4(in)-268.6(comparison)-270.5(with)-275(those)-270.7(of)-267.2(RESCUEicp.)]TJ
0 -1.2266 TD
[(Translation)-369.2(into)-366.5(clinical)-367.2(practice)-370.5(requires)-365.4(careful)-373.5(examination)-365.2(of)]TJ
0 -1.2203 TD
[(both)-280.3(randomized)-284.4(trials.)]TJ
/F1 1 Tf
0 -3.3638 TD
(Methods)Tj
/F4 1 Tf
1.1128 -1.7451 TD
[(The)-241(design,)-241.6(patient)-241.1(inclusion)-238.9(and)-241.2(exclusion)-243.6(criteria,)-238.5(procedures,)]TJ
-1.1128 -1.1128 TD
[(assessments,)-467.2(outcome)-457.9(measures,)-463.7(study)-458(oversight,)-461.7(and)-462.5(statistical)]TJ
T*
[(analysis)-220(of)-216.6(the)-213.6(DECRA)-222.1(trial)-217(have)-217.9(been)-217.9(previously)-218(described.)]TJ
6.7246 0 0 5.9768 276.2078 61.2283 Tm
(12)Tj
8.9663 0 0 8.9663 284.8818 57.2598 Tm
(The)Tj
2.8959 74.5598 TD
[(surgical)-316.3(procedure)-324.2(was)-321.6(a)-318.1(modication)-317.1(of)-317.8(the)-321.1(Kjellberg)-321.9(method,)]TJ
6.7246 0 0 5.9768 543.1747 729.751 Tm
(16)Tj
8.9663 0 0 8.9663 310.8472 715.8046 Tm
[(which)-310.8(had)-310.8(tested)-314.6(favorably)-313.2(in)-306.5(a)-311.7(cohort)-315.9(study.)]TJ
6.7246 0 0 5.9768 476.3904 719.7731 Tm
(17)Tj
8.9663 0 0 8.9663 485.9149 715.8046 Tm
[(The)-310.6(only)-311.9(surgical)]TJ
-19.5252 -1.1128 TD
[(modication)-393(entailed)-401.1(not)-394.6(dividing)-393.9(the)-397(sagittal)-397.6(sinus)-396(and)-399.3(falx,)-395.7(to)]TJ
0 -1.1065 TD
[(minimize)-228.7(complications,)-227(decrease)-233.3(anterior)-229.2(herniation)-229.6(of)-229.3(the)-226.3(frontal)]TJ
0 -1.1128 TD
[(lobes,)-532.9(and)-532.1(increase)-532.1(generalizability.)]TJ
6.7246 0 0 5.9768 447.1936 689.8959 Tm
(18)Tj
8.9663 0 0 8.9663 458.7022 685.9274 Tm
[(Randomization)-533.4(occurred)]TJ
-16.4902 -1.1128 TD
[(after)-214(ICU)-217.8(admission,)-217.2(when)-212.4(ICP)-219.4(had)-215.9(increased)-215.4(sufciently)-216.2(to)-218(satisfy)]TJ
0 -1.1065 TD
[(the)-295.8(enrollment)-302.7(criteria.)]TJ
6.7246 0 0 5.9768 394.0723 669.9967 Tm
(12)Tj
8.9663 0 0 8.9663 403.4834 666.0282 Tm
[(Patients)-303.6(in)-293.9(the)-302.2(intensive)-298.2(medical)-306.3(control)]TJ
-10.3316 -1.1128 TD
[(group)-354.2(could)-351.8(receive)-360.6(barbiturate)-360.6(infusions)-356.4(to)-350.8(control)-357.4(ICP,)-355.1(but)-356.6(not)]TJ
T*
[(hypothermia.)-484.5(Baseline)-491.5(variables)-482.6(were)-489.3(well)-486(matched)-485.6(except)-488.9(for)]TJ
T*
[(pupil)-347(reactivity)-349.8(at)-346.9(hospital)-346.9(admission,)-350(and)-348.7(outcomes)-344.8(at)-346.9(6)-347.3(months)]TJ
0 -1.1065 TD
[(favored)-278.5(the)-283.2(intensive)-279.3(medical)-287.3(control)-281.5(group.)]TJ
1.1128 -1.1128 TD
[(Functional)-516.4(outcome)-521.1(assessments)-521.2(were)-520.9(conducted)-525.4(by)-517.5(trained)]TJ
-1.1128 -1.1128 TD
[(assessors,)-366(blind)-372.3(to)-363.4(treatment)-368.8(group,)-369.8(using)-363.2(standardized)-376.1(question-)]TJ
T*
(naires.)Tj
6.7246 0 0 5.9768 334.5448 600.2644 Tm
(15,19)Tj
8.9663 0 0 8.9663 353.8771 596.2392 Tm
[(Functional)-459.5(outcome)-464.2(assessments)-464.3(at)-467(12)-460.6(months)-461.1(after)]TJ
-4.7991 -1.1065 TD
[(injury,)-567.1(and)-570(among)-572.6(survivors)-570(at)-568.2(6)-568.6(and)-570(12)-568.1(months,)-571.5(were)-571.5(pre-)]TJ
0 -1.1128 TD
(planned)Tj
6.7246 0 0 5.9768 339.307 580.3085 Tm
(14)Tj
8.9663 0 0 8.9663 350.1353 576.34 Tm
[(and)-462.5(measured)-459.6(by)-454.3(the)-460.2(score)-461.4(on)-454.3(the)-460.2(GOS-E,)-457(which)-462.6(is)]TJ
-4.3818 -1.1128 TD
[(scored)-195.4(from)-202.8(1)-195.5(\(dead\))-196.8(to)-199.1(8)-195.5(\(pre-injury)-198.9(function\).)]TJ
6.7246 0 0 5.9768 477.1841 570.3873 Tm
(20)Tj
8.9663 0 0 8.9663 485.688 566.3621 Tm
[(Among)-200.4(survivors,)]TJ
-19.4999 -1.1065 TD
[(favorable)-182.8(outcomes)-186.7(were)-185.8(calculated)-183.7(as)-186(the)-182(ratio)-187.7(of)-185(GOS-E)-182.2(scores)-183.9(5)]TJ
0 -1.1128 TD
[(8)-265.1(over)-268.6(28,)-267(and)-272.8(good)-263.6(outcomes)-268.9(as)-268.2(GOS-E)-270.7(scores)-272.4(of)-267.2(78)-270.4(over)-268.6(28.)]TJ
1.1128 -1.1128 TD
[(Functional)-352(\(GOS-E\))-357.2(outcomes)-357.4(were)-356.5(dichotomized)-352.1(as)]TJ
/F5 1 Tf
22.1049 0 TD
(unfavor-)Tj
-23.2177 -1.1128 TD
(able)Tj
/F4 1 Tf
2.1245 0 TD
[(\(14)-392.7(vs.)-395.1(58\),)-389.3(and)-399.3(analyzed)-395.5(using)-394.8(logistic)-395.2(regression.)-393.8(Out-)]TJ
-2.1245 -1.1065 TD
[(comes)-203.1(\(GOS-E\))-211.7(on)-207.7(a)-204.3(18)-207.2(scale)-206(were)-211.1(analyzed)-205.8(using)-205.1(ordinal)-205.7(logistic)]TJ
0 -1.1128 TD
[(regression.)-216.8(Among)-213.1(survivors)-215.9(at)-220.4(6)-214.5(and)-215.9(12)-214(months)-214.5(after)-220.3(injury,)-213(GOS-)]TJ
T*
[(E)-309.1(outcomes)-313.2(were)-318.6(analyzed)-313.3(using)-312.6(logistic)-313(regression)-315.1(for)-313.6(favorable)]TJ
T*
[(outcomes,)-189.6(and)-190.6(for)-187.1(three)-186.1(additional)-193.1(dichotomies:)]TJ
/F5 1 Tf
19.0509 0 TD
(vegetative)Tj
/F4 1 Tf
4.268 0 TD
[(\(2)-191.3(vs.)-186.5(3)]TJ
-23.3189 -1.1065 TD
(8\),)Tj
/F5 1 Tf
1.3152 0 TD
[(poor)-239.5(outcomes)]TJ
/F4 1 Tf
6.1395 0 TD
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[(An)-217.3(u)13.1(n)0(p)19.9(l)0(a)13.5(n)13.1(n)13.1(e)0(d)-222.7(e)0(x)23.9(p)0(l)15.9(o)13.1(ra)14.9(to)22.2(ry)-216.6(as)16.3(-t)19.6(re)21.2(at)19.8(ed)-222.7(an)23.9(al)13.5(y)13.1(s)0(i)21.1(s)-228.3(wa)14.2(s)-222(a)0(l)13.5(s)0(o)-215.2(c)0(o)17.5(n)13.1(du)19.9(ct)19.8(ed)]TJ
-1.1128 -1.1128 TD
[(of)-159.7(al)19.8(l)-174.3(p)13.1(at)19.8(ie)13.5(n)13.1(t)0(s)-162.3(w)0(h)23(o)-170.2(re)14.9(ce)21.4(iv)15.9(ed)-159.5(a)-172.6(d)13.1(ec)15.1(o)13.1(m)0(p)16.4(r)0(e)21.2(s)0(s)17.6(i)0(v)22.2(e)-172.6(cr)21.2(an)17.5(ie)19.8(ct)19.8(om)16.4(y)-170.2(a)0(t)-157.2(a)0(n)17.5(y)-170.2(ti)18.2(me)]TJ
T*
[(af)21.2(te)13.5(r)-223.4(r)0(a)14.9(n)13.1(do)19.9(mi)18.7(za)21.4(ti)18.2(on)-220.3(co)23.9(mp)16.4(ar)21.2(ed)-222.7(wi)18.9(t)15.4(h)-227.1(al)13.5(l)-224.8(t)0(h)22.2(o)0(s)18.8(e)-229.6(wh)16.6(o)-227.1(d)13.1(id)-218(no)19.9(t,)-215.1(re)14.9(g)13.1(a)0(r)14.9(d)13.1(le)19.8(ss)]TJ
0 -1.1065 TD
[(of)-216.6(ra)21.2(nd)19.9(om)16.4(i)15.4(z)0(e)15.1(d)-220.8(gr)17.3(ou)19.9(p)13.1(.)-224.2(We)-218.3(wi)18.9(sh)18.8(ed)-216.4(to)-211.7(ex)17.5(p)13.1(l)0(o)15.9(r)0(e)-212.7(t)0(h)22.3(e)-229.6(ef)21.2(fe)21.2(ct)-220.4(o)13.1(n)-227.1(o)13.1(u)0(r)-216.6(r)0(e)21.3(s)0(u)18.8(l)0(t)18.2(s)]TJ
0 -1.1128 TD
[(of)-330.4(th)15.9(e)-343.4(1)13.1(8%)-329.9(of)-336.7(st)21.1(an)17.5(d)13.1(a)0(r)14.9(d)-340.9(ca)21.4(re)-332.8(pa)17.5(ti)18.2(en)23.9(ts)-333(wh)16.6(o)-340.9(h)13.1(ad)-336.6(re)21.2(ce)15.1(iv)22.2(ed)-330.2(a)-343.4(l)0(a)19.8(t)0(e)-334.3(c)0(r)14.9(a)0(-)]TJ
T*
[(ni)22.2(ec)15.1(to)22.2(my)-293.4(as)-293.5(p)13.1(e)0(r)21.2(m)0(i)18.7(t)0(t)18.2(e)0(d)-292.3(i)0(n)-287.6(t)0(h)15.9(e)-299.1(p)13.1(r)0(o)17.3(t)0(o)22.2(c)0(o)17.5(l)-300.7(as)-293.5(a)-299.1(l)0(i)18.2(f)0(e)21.2(-)0(s)16.2(a)0(v)23.9(i)0(n)15.9(g)-296.7(in)15.9(te)19.8(rv)17.3(en)23.9(ti)18.2(on)20(.)]TJ
T*
[(Ow)19.7(in)15.9(g)-328.3(t)0(o)-319.2(l)0(i)24.6(k)0(e)17.5(l)0(y)-319.2(i)0(m)18.7(b)13.1(al)13.5(an)23.9(ce)-320(in)-319.2(se)16.3(v)13.1(e)0(r)14.9(i)0(t)18.2(y)13.1(,)-331.7(a)0(l)19.8(l)-326(th)15.9(es)22.7(e)-330.7(a)0(n)17.5(a)0(l)19.8(y)13.1(se)16.3(s)-329.5(w)0(e)20.5(r)0(e)-320.2(a)0(d)17.5(-)]TJ
0 -1.1065 TD
[(ju)22.2(st)14.7(ed)-260.7(fo)23.7(r)-274(t)0(h)22.2(e)-273.8(IM)23(PA)18.1(CT)-262.8(co)23.9(re)-263.3(pr)17.3(o)13.1(b)0(a)17.5(b)13.1(il)18.2(it)18.2(y)-271.4(o)13.1(f)-274(u)13.1(nf)17.3(av)17.5(o)13.1(r)0(a)21.2(b)0(l)15.9(e)-267.5(ou)19.9(tc)19.8(om)16.4(e.)]TJ
/F1 1 Tf
0 -2.6177 TD
(Results)Tj
/F4 1 Tf
1.1128 -1.8336 TD
[(One)-282.5(hundred)-279.8(fty-ve)-289.4(patients)-279.7(were)-287(randomized,)-287.3(73)-277.2(to)-287.6(decom-)]TJ
-1.1128 -1.2203 TD
[(pressive)-300.8(craniectomy)-303(and)-298.1(82)-302.5(to)-300.2(standard)-299.6(care.)-301.7(Baseline)-301.8(character-)]TJ
T*
[(istics)-260.5(including)-256.7(pupil)-258.5(reactivity)-255(at)-258.4(randomization)-259.4(in)-256(ICU)-262.1(\(84%)-255.7(and)]TJ
0 -1.2266 TD
[(87%\))-287.3(and)-285.5(IMPACT)-291.3(probability)-287.6(of)-286.2(a)-286.5(poor)-285.2(outcome)-287.2(\(42%)-287.3(and)-285.5(42%)]TJ
0 -1.2203 TD
[(using)-426.4(IMPACT)-430.4(core\))-424.9(were)-432.4(similar)-429.4(between)-428.5(groups)-424.5(\(Table)-425.7(1\).)]TJ
6.7246 0 0 5.9768 294.4062 357.1086 Tm
(12)Tj
8.9663 0 0 8.9663 62.022 342.1983 Tm
[(Pupil)-364.6(reactivity)-368.8(at)-365.9(randomization)-366.9(was)-365.8(considered)-364.3(the)-365.4(optimal)-362.4(in-)]TJ
0 -1.2266 TD
[(dicator)-283.9(of)-279.8(post-resuscitation)-286.6(neurological)-281.6(activity.)]TJ
29.1107 44.0075 TD
[(After)-417.2(randomization,)-420.4(more)-417.6(standard)-413.4(care)-418.9(patients)-418.8(\(77%\))-415.9(than)]TJ
-1.1128 -1.2203 TD
[(patients)-336.7(with)-331.9(craniectomy)-328.3(\(32%\))-333.7(required)-332.6(barbiturates)-329.7(to)-331.8(manage)]TJ
0 -1.2266 TD
[(ICP)-459.7(\()]TJ
/F5 1 Tf
2.5102 0 TD
(p)Tj
/F6 1 Tf
.6639 0 TD
(<)Tj
/F4 1 Tf
.7208 0 TD
[(0.001\),)-454.9(more)-449.2(required)-459.1(high)-451(total)-454.6(doses)-457.6(of)-456.9(barbiturates)]TJ
-3.8949 -1.2203 TD
(\()Tj
/F6 1 Tf
.3351 0 TD
(>)Tj
/F4 1 Tf
.5501 0 TD
[(30)-169.7(g;)-319.2(17%\))-318.9(compared)-319.3(with)-319.2(zero)-321.6(in)-319.2(patients)-317.7(with)-319.2(craniectomy.)]TJ
6.7246 0 0 5.9768 545.4424 696.8691 Tm
(22)Tj
8.9663 0 0 8.9663 313.0582 681.9589 Tm
[(Further,)-332.2(the)-327.4(post-randomization)-328(median)-331.9(total)-328.2(dose)-324.1(of)-330.4(barbiturates)]TJ
0 -1.2266 TD
[(received)-259(by)-258.3(standard)-255.3(care)-254.5(patients)-260.8(\(6.5)-168.5(g,)-249(interquartile)-260.2(range)-257.9([IQR])]TJ
0 -1.2203 TD
[(0.5020\))-362.5(was)-365.8(substantially)-368.7(greater)-360.8(than)-364.9(that)-362.6(received)-366.5(by)-365.7(patients)]TJ
T*
[(with)-281.3(craniectomy)-284(\(0.00)-168(g,)-280.6(IQR)-281(0.001.03,)]TJ
/F5 1 Tf
17.1161 0 TD
(p)Tj
/F6 1 Tf
.6702 0 TD
(<)Tj
/F4 1 Tf
.7208 0 TD
(0.001\).)Tj
-17.3943 -1.2266 TD
[(As)-237.5(previously)-237(reported,)]TJ
6.7246 0 0 5.9768 407.2818 642.1038 Tm
(12)Tj
8.9663 0 0 8.9663 416.1259 638.0786 Tm
[(short-term)-239.4(outcomes)-237.3(in)-237(the)-238.9(ICU)-236.8(in)-237(the)]TJ
-11.4951 -1.2203 TD
[(craniectomy)-448.4(group)-442.8(compared)-445.8(with)-445.7(the)-447.6(standard)-445(care)-444.2(group)-442.8(had)]TJ
T*
[(improved,)-226.6(including)-218.7(lower)-218.6(ICP,)-222.3(fewer)-219.6(interventions)-220.7(to)-224.3(control)-218.3(ICP,)]TJ
T*
[(and)-563.7(fewer)-567.3(days)-564.4(receiving)-569.9(mechanical)-562.5(ventilation)-569.7(in)-559.5(the)-567.7(ICU.)]TJ
0 -1.2266 TD
[(Standard)-423.5(care)-418.9(patients)-418.8(also)-416.7(often)-423.9(received)-417.1(high-dose)-416.8(barbiturate)]TJ
0 -1.2203 TD
[(infusions)-286.8(to)-274.9(control)-281.5(their)-282.5(ICP.)]TJ
1.1128 -1.2203 TD
[(Tw)16.8(el)19.8(ve)-153.2(mo)22.7(nt)15.9(h)13.1(s)-165.1(af)21.2(te)19.8(r)-166.5(i)0(n)22.3(j)0(u)15.9(r)0(y)23.7(,)-161(no)-157.1(p)13.1(a)0(t)19.8(i)0(e)19.8(n)0(t)15.9(s)-158.8(we)14.2(re)-149.5(lo)15.9(st)-149.7(to)-154.8(fo)17.3(l)15.4(l)0(o)15.9(w)0(-)20.4(u)0(p)19.9(,)-161(an)17.5(d)]TJ
-1.1128 -1.2266 TD
[(al)13.5(l)-256.4(1)13.1(55)-251.9(p)13.1(a)0(t)13.5(i)15.4(en)17.5(ts)-250.8(\(1)17.3(0)13.1(0)13.1(%)0(\))-250.3(h)0(a)17.5(d)-258.8(n)13.1(e)0(u)17.5(r)0(o)17.3(l)0(o)22.3(g)0(i)15.9(c)0(a)21.4(l)-256.4(fu)17.3(nc)17.5(ti)18.2(o)13.1(n)-258.7(as)16.3(se)22.7(ss)17.6(ed)-248(\(F)18.8(ig)22.3(.)-262.2(1)13.1(\).)]TJ
0 -1.2203 TD
-.0189 Tc
[(F)-18.9(o)-3.9(r)-413(a)-419.2(p)-5.8(a)-18.9(ti)-18.9(en)-18.9(t)-407.6(p)-18.9(ar)-18.9(ti)-18.9(ci)-18.9(pa)-18.9(ti)-18.9(on)-416.8(d)-5.8(i)-18.9(ag)-18.9(ra)-18.9(m)-403.2(t)-18.9(o)-407.6(1)-18.9(2)-403.6(m)-18.9(on)-5.8(t)-18.9(h)-3(s)-411.6(s)-18.9(ee)-412.8(t)-18.9(h)-3(e)-412.8(s)-18.9(up)-18.9(pl)-18.9(e-)]TJ
T*
0 Tc
[(me)14(n)13.1(t)0(a)19.8(r)0(y)-248.2(a)0(p)17.5(p)13.1(en)17.5(d)13.1(i)0(x)-243.3(p)0(u)20(b)0(l)15.9(i)0(s)21.1(h)0(e)17.5(d)-252.4(pr)17.3(ev)17.5(i)15.4(o)0(u)20(s)0(l)14.7(y)13.1(.)]TJ
6.7246 0 0 5.9768 454.6204 543.4581 Tm
(22)Tj
8.9663 0 0 8.9663 463.5778 539.4896 Tm
[(Un)23(li)18.2(k)13.1(e)-261.2(t)15.4(h)0(e)-248(p)0(r)17.3(e)0(v)23.9(i)0(o)15.9(u)13.1(sl)14.7(y)-252.4(r)0(e)21.2(-)]TJ
-16.7873 -1.2266 TD
[(po)19.9(rt)19.6(ed)-134.2(6-)17.3(mo)22.7(nt)15.9(h)-144.9(r)0(e)21.2(s)0(u)18.8(l)0(t)18.2(s)0(,)-130.1(a)0(t)-131.9(1)0(2)-138.1(m)0(o)22.7(n)0(t)15.9(h)13.1(s,)-136.4(t)15.4(h)0(e)-134.2(f)0(u)17.3(n)13.1(ct)13.5(io)22.3(n)13.1(a)0(l)-138.2(a)0(s)22.7(s)0(e)16.3(s)0(s)17.6(m)0(e)20.3(n)13.1(t)-149(o)13.1(n)-144.9(t)0(h)22.3(e)]TJ
0 -1.2203 TD
[(GO)13.3(S)14.6(-)0(E)-153.2(\()0(O)20.4(R)-162.3(fo)17.3(r)-160.2(a)-160(wo)16.6(rs)22.5(e)-166.3(f)0(u)23.7(n)0(c)17.5(t)0(i)18.2(o)13.1(na)17.5(l)-161.6(o)13.1(ut)15.9(co)17.5(me)-150.4(in)-148.5(th)15.9(e)-160(c)0(r)21.3(a)0(n)17.5(i)0(e)19.8(c)0(t)19.8(o)0(m)16.4(y)-157.6(gr)17.3(o)13.1(u)0(p)]TJ
T*
[(1.)16.5(6)13.1(8)0(;)-414(9)13.1(5%)-412.1(CI)18.9(:)-420.8(0)13.1(.9)16.5(6)13.1(-)0(2)17.3(.)0(9)22.9(3)0(;)]TJ
/F5 1 Tf
10.7742 0 TD
(p)Tj
/F6 1 Tf
.6576 0 TD
(=)Tj
/F4 1 Tf
.7082 0 TD
[(0)13.1(.)0(0)16.5(7)13.1(\),)-409.7(al)19.8(th)15.9(o)13.1(u)0(g)19.9(h)-423.1(co)23.8(nc)17.5(er)21.3(ni)15.9(n)13.1(g)0(,)-413.4(w)0(a)20.5(s)-418(no)]TJ
-12.14 -1.2203 TD
[(lo)15.9(n)13.1(g)0(e)17.5(r)-381.5(si)21.1(gn)19.9(i)17.3(ca)21.4(nt)15.9(ly)-369.8(wo)16.6(rs)22.5(e)-381.3(i)0(n)-376.1(t)0(h)22.3(e)-381.3(cr)14.9(an)23.9(ie)13.5(ct)19.8(o)13.1(m)0(y)-375.6(g)13.1(ro)17.3(u)13.1(p)0(.)-375.5(U)0(n)23(f)0(a)21.2(v)0(o)20(r)0(a)14.9(b)13.1(le)]TJ
0 -1.2266 TD
[(ou)19.9(tc)13.5(o)13.1(m)0(e)20.3(s)-165.1(o)13.1(c)0(c)15.1(u)13.1(rr)21.1(ed)-153.2(in)-154.8(4)13.1(3)-163.9(p)13.1(a)0(t)19.8(i)0(e)19.8(n)0(t)15.9(s)-158.8(\(5)17.3(9)13.1(%)0(\))-155.5(i)0(n)-148.5(t)0(h)22.3(e)-166.3(cr)21.2(an)17.5(ie)19.8(ct)19.8(om)16.4(y)-157.6(g)0(r)17.3(o)13.1(up)-150.8(an)17.5(d)]TJ
0 -1.2203 TD
[(in)-256(3)13.1(9)-258.8(pa)17.5(ti)18.2(en)17.5(t)15.4(s)-259.9(\(4)17.3(8%)17.8(\))-261.4(i)0(n)-249.6(s)0(t)21.1(a)0(n)17.5(d)13.1(ar)14.9(d)-258.7(c)0(a)21.4(r)0(e)-250.6(\()0(O)14(R)-257.1(1.)16.5(5)13.1(8)0(;)-249.6(9)0(5)19.9(%)-260.9(CI)18.9(:)-262.8(0)13.1(.8)22.9(4-)17.3(2.)16.5(9)13.1(9)0(;)]TJ
/F5 1 Tf
T*
(p)Tj
/F6 1 Tf
.6576 0 TD
(=)Tj
/F4 1 Tf
.7082 0 TD
[(0.)16.5(1)13.1(6)0(\))-368.4(\()0(T)17.5(a)0(b)23.9(l)0(e)-372.2(2)13.1(\).)-365.4(Af)20.4(te)19.8(r)-381.5(a)0(d)23.9(j)0(u)15.9(s)0(t)21.1(m)0(e)20.3(n)0(t)-369.8(f)0(o)23.7(r)-375.2(IM)16.6(PA)18.1(CT)-364(co)17.5(re)-364.4(sc)16.3(o)13.1(r)0(e)-370.8(t)0(h)22.3(e)]TJ
-1.3658 -1.2266 TD
[(re)14.9(su)18.8(lt)24.5(s)-158.8(w)0(e)14.2(r)0(e)-143.1(s)0(i)14.7(m)0(i)25(l)0(a)13.5(r)-153.9(\(T)17.5(ab)17.5(l)15.4(e)-160(3\))17.3(.)-154.7(I)0(n)-147.1(s)0(u)18.8(m)0(m)19.2(a)0(r)21.2(y)0(,)-147.9(1)13.1(2)-157.6(m)0(o)16.4(n)13.1(th)15.9(s)-152.4(a)0(f)14.9(t)0(e)19.8(r)-153.9(TB)15.4(I)-153.9(s)0(o)18.7(m)0(e)]TJ
0 -1.2203 TD
[(pa)17.5(ti)18.2(en)17.5(ts)-288.8(wh)16.6(o)-296.7(h)0(a)17.5(d)-303(u)13.1(n)0(f)17.3(a)0(v)23.9(o)0(r)17.3(a)0(b)17.5(l)0(e)-290(o)13.1(ut)15.9(co)17.5(me)20.3(s)-297.9(a)0(t)-296.3(6)-296.7(mo)16.4(n)13.1(t)0(h)22.2(s)-304.2(h)13.1(a)0(d)-292.3(i)0(m)18.7(p)0(r)17.3(o)13.1(ve)17.5(d)]TJ
T*
[(su)18.8(f)18.8(ci)19.8(en)17.5(tl)18.2(y)-372.6(t)15.4(ha)17.5(t)-370.3(t)0(h)15.9(e)-368.7(tr)19.6(en)17.5(d)-372.6(t)0(o)-357.1(w)0(o)16.6(r)0(s)22.5(e)-375(fu)23.7(nc)17.5(ti)18.2(o)13.1(n)0(a)17.5(l)-370.3(ou)19.9(tc)19.8(om)16.4(es)-363(af)21.3(te)19.8(r)-375.2(c)0(r)21.2(a)0(-)]TJ
0 -1.2266 TD
[(ni)15.9(ec)21.4(to)15.9(my)-230.2(wa)20.5(s)-241(n)13.1(o)-239.8(l)0(o)15.9(n)13.1(ge)17.5(r)-242.4(s)0(i)21.1(g)13.1(ni)15.9(c)19(an)17.5(t)15.4(.)]TJ
1.1128 -1.2203 TD
[(T)-12(w)-9.1(e)-14.6(l)-9.9(ve)-279.6(m)-9.4(o)-12.2(n)-12.2(t)-9.9(hs)-284.7(a)-8.2(f)-8.4(t)-9.9(e)-14.6(r)-274(i)-9.8(nj)-15.7(u)-12.2(r)-8.4(y)-12.2(,)-274.8(a)-273.8(t)-9.9(ot)-15.7(a)-14.6(l)-275.4(of)-279.8(1)-12.2(5)-271.4(p)-12.2(a)-8.3(t)-9.9(i)-9.9(e)-14.6(nt)-15.7(s)-272.6(\()-14.8(21)-18(%)-7.9(\))-274(i)-9.9(n)-271.4(t)-16.2(h)0(e)]TJ
-1.1128 -1.2203 TD
.0139 Tc
[(cr)5.5(an)13.9(iec)5.7(t)4(om)4.5(y)-301.8(g)1.7(r)5.5(o)13.9(up)-301.8(an)13.9(d)-307.6(1)1.7(6)-301.8(\()5.5(19)13.9(%)-6.2(\))-298(in)-301.8(the)-304.2(s)6.9(tan)13.9(d)-4.1(ar)5.5(d)-301.8(c)5.6(ar)5.5(e)-304.2(g)13.9(r)-6.7(o)13.9(up)-301.8(ha)5.6(d)]TJ
0 -1.2266 TD
.0111 Tc
[(died)11.1(.)-421.3(A)-4.4(mo)11.1(n)-6.9(g)-418.4(th)11.1(e)-426.6(s)4.1(urvivo)11.1(rs)-419.6(at)-416.1(12)-418.4(mo)11.1(n)-6.9(t)1.2(hs)4.1(,)-415.5(v)-1.1(egetative)-414.5(o)-1.1(u)11.1(t)-4.6(comes)]TJ
0 -1.2203 TD
.0109 Tc
[(occurred)-247.9(i)1(n)-254.2(1)10.9(4)-7.1(%)-250(of)-250.5(the)-250.3(c)-3.7(raniectomy)-247.8(group)10.9(,)-257.1(c)-3.7(o)10.9(m)-4.3(pared)-254.2(w)1.8(ith)-254.2(3)10.9(%)-262.1(o)10.9(f)]TJ
T*
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