• Ava M Puccio, Michael R Fischer, Brian T Jankowitz, Howard Yonas, Joseph M Darby, and David O Okonkwo.
• Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, B-400 PUH, Pittsburgh, PA 15213, USA. puccioam@upmc.edu
• Neurocrit Care. 2009 Jan 1;11(1):82-7.

IntroductionHyperthermia following a severe traumatic brain injury (TBI) is common, potentiates secondary injury, and worsens neurological outcome. Conventional fever treatment is often ineffective. An induced normothermia protocol, utilizing intravascular cooling, was used to assess the impact on fever incidence and intracranial pressure (ICP) in patients with severe TBI.MethodsA comparative cohort study of 21 adult patients with severe TBI (GCS 25 mmHg was calculated for the initial 72-h monitoring period. Non-parametric rank tests were performed.ResultsMean (+/-SD) or median [range] demographics did not differ between groups [total N = 42 (6 female, 36 male, age 36.4 +/- 14.8 years and initial GCS 7 [3-8], median and range]. Fever burden in the first 3 days (time >38 degrees C) in the induced normothermia versus control group was significantly less at 1.6% versus 10.6%, respectively (P = 0.03). Mean ICP for patients with induced normothermia versus control was 12.74 +/- 4.0 and 16.37 +/- 6.9 mmHg, respectively. Furthermore, percentage of time with ICP > 25 mmHg was significantly less in the induced normothermia group (P = 0.03).ConclusionInduced normothermia (fever prophylaxis via intravascular cooling catheter) is effective in reducing fever burden and may offer a means to attenuate secondary injury, as evidenced by a reduction in the intracranial hypertension burden.

21 keywords...

hide…