• Mauro Oddo, Suzanne Frangos, Andrew Milby, Isaac Chen, Eileen Maloney-Wilensky, Eileen Mac Murtrie, Michael Stiefel, W Andrew Kofke, Peter D Le Roux, and Joshua M Levine.
• Department of Neurosurgery, Clinical Research Division, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA. Mauro.Oddo@uphs.upenn.edu
• Stroke. 2009 May 1; 40 (5): 1913-6.

Background And PurposeThe purpose of this study was to analyze whether fever control attenuates cerebral metabolic distress after aneurysmal subarachnoid hemorrhage (SAH).MethodsEighteen SAH patients, who underwent intracranial pressure (ICP) and cerebral microdialysis monitoring and were treated with induced normothermia for refractory fever (body temperature >or=38.3 degrees C, despite antipyretics), were studied. Levels of microdialysate lactate/pyruvate ratio (LPR) and episodes of cerebral metabolic crisis (LPR >40) were analyzed during fever and induced normothermia, at normal and high ICP (>20 mm Hg).ResultsCompared to fever, induced normothermia resulted in lower LPR (40+/-24 versus 32+/-9, P<0.01) and a reduced incidence of cerebral metabolic crisis (13% versus 5%, P<0.05) at normal ICP. During episodes of high ICP, induced normothermia was associated with a similar reduction of LPR, fewer episodes of cerebral metabolic crisis (37% versus 8%, P<0.01), and lower ICP (32+/-11 versus 28+/-12 mm Hg, P<0.05).ConclusionsFever control is associated with reduced cerebral metabolic distress in patients with SAH, irrespective of ICP.

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