Hyperthermia following traumatic brain injury: a critical evaluation

@article{Thompson2003HyperthermiaFT,
  title={Hyperthermia following traumatic brain injury: a critical evaluation},
  author={Hilaire J. Thompson and Nancy Tkacs and Kathryn Saatman and Ramesh Raghupathi and Tracy K. Mcintosh},
  journal={Neurobiology of Disease},
  year={2003},
  volume={12},
  pages={163-173}
}
Hyperthermia, frequently seen in patients following traumatic brain injury (TBI), may be due to posttraumatic cerebral inflammation, direct hypothalamic damage, or secondary infection resulting in fever. Regardless of the underlying cause, hyperthermia increases metabolic expenditure, glutamate release, and neutrophil activity to levels higher than those occurring in the normothermic brain-injured patient. This synergism may further compromise the injured brain, enhancing the vulnerability to… Expand
View on Elsevier
doi.org
137 Citations
Highly Influential Citations
4
Background Citations
31

137 Citations

Citation Type

Citation Type

Hyperthermia and central nervous system injury.
TLDR
Evidence regarding hyperthermia and CNS injury is summarized and increased emphasis on the ability to monitor CNS temperature and prevent periods of fever has gained increased attention in the clinical literature. Expand
Thermoregulation in brain injury.
TLDR
Given the deleterious effects of fever, aggressive fever management is still warranted in the critically ill neurologic patient, and targeted temperature management (TTM) exerts pleiotropic effects. Expand
Brain hyperthermia after traumatic brain injury does not reduce brain oxygen.
TLDR
Direct brain oxygen (BtO2) and brain temperature (BT) monitoring can help guide the management of severely brain-injured patients and may be mediated by increased cytokine release and inflammation or by increased energy expenditure and a widened metabolic gap. Expand
Current trends in neurotrauma care
TLDR
Evidence is also mounting that guided therapy using brain tissue oxygenation in addition to intracranial pressure and cerebral perfusion pressure monitoring leads to better outcomes after traumatic brain injury. Expand
Systemic Hyperthermia in Traumatic Brain Injury—Relation to Intracranial Pressure Dynamics, Cerebral Energy Metabolism, and Clinical Outcome
TLDR
Hyperthermia was most common between days 6 and 10 following TBI, and associated with disturbances in cerebral energy metabolism but not worse clinical outcome, and there was no association between hyperthermia and worse clinical outcomes. Expand
Hyperthermia and fever control in brain injury
TLDR
Data support that the impact of fever is sustained for longer durations after subarachnoid hemorrhage and traumatic brain injury, and prospective randomized trials are needed to determine whether the beneficial impact of secondary injury prevention is outweighed by the potential risks of prolonged fever control. Expand
Targeted Temperature Management in Pediatric Central Nervous System Disease
TLDR
Data in children from prospective, randomized controlled trials using different strategies of targeted temperature management for various outcomes are few, but a large study examining HT versus controlled normothermia to improve neurological outcome in cardiac arrest is underway. Expand
Paroxysmal episodic hypothalamic instability with hypothermia after traumatic brain injury
TLDR
The manifestations in this patient have been interpreted as possible consequences of autonomic dysfunction and considered atypical and rare clinical expression of acute post-traumatic hypothalamic instability. Expand
The effect of hypothermia and hyperthermia on acute brain injury.
TLDR
The pathophysiology of secondary brain injury and how it is affected by both hypothermia and hyperthermia is presented, as well as a discussion of the future of temperature modulation for the brain injury patient. Expand
BRAIN HYPERTHERMIA AFTER TRAUMATIC BRAIN INJURY DOES NOT REDUCE BRAIN OXYGEN
TLDR
In this clinical study, hyperthermia does not seem to reduce BtO2 or increase the number of episodes of brain tissue hypoxia in patients with severe TBI, and results suggest thatHyperthermia may worsen outcome after TBI through mechanisms that may be separate from compromised brain oxygen. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 100 REFERENCES
Post-traumatic hyperthermia in acute brain injury rehabilitation.
TLDR
A fever protocol is described that should aid the physician in diagnosis and treatment of the febrile TBI patient and proposed mechanisms involved in thermoregulation are discussed. Expand
Management of hyperthermia in traumatic brain injury
TLDR
Despite a sound physiologic argument for controlling fever in the brain-injured patient, there is no evidence that doing so will improve outcome and several treatment options for controlling temperature are discussed. Expand
Fever After Traumatic Brain Injury
  • M. Segatore
  • Medicine
  • The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
  • 1992
TLDR
Given the potential benefit of fever the ability of most patients to tolerate temperature elevations and the adverse effects, costs and discomforts associated with therapy, the habit of automatically reducing temperature should be examined. Expand
DEFECTIVE THERMOREGULATION AFTER TRAUMATIC BRAIN INJURY: A Single Subject Evaluation1
TLDR
A patient who had central fevers acutely after injury, but developed intermittent temperature elevations during thermal stress in the post-acute phase suggests that the patient had a chronic deficit in either sensing temperature Elevations or activating heat dissipation mechanisms under thermal stress. Expand
The importance of brain temperature in cerebral injury.
TLDR
Findings demonstrating the importance of brain temperature in ischemic and traumatic brain injury are discussed and potential mechanisms by which mild hypothermia may attenuate and mild hyperthermia accentuate the detrimental consequences of brain injuryare reviewed. Expand
Therapeutic moderate hypothermia and fever.
  • D. Marion
  • Medicine
  • Current pharmaceutical design
  • 2001
TLDR
Based on a phase-I trial, it appears that intravascular cooling is a promising new method for avoiding fever in the neurosurgical ICU. Expand
Occurrence of potentially detrimental temperature alterations in hospitalized patients at risk for brain injury.
TLDR
In these hospitalized patients at risk for ongoing brain injury, the incidence of temperature increases within the range reported to worsen neurologic outcome (elevations of 1.0 degree C or more) was very high. Expand
Fever of central origin in traumatic brain injury controlled with propranolol.
TLDR
Central fevers after TBI have been reported to have been treated successfully with propranolol in two children with decerebrate posturing, and evidence of a significant central nervous system role in the regulation of blood pressure and temperature is provided. Expand
Incidence of fever in the rehabilitation phase following brain injury.
TLDR
There appears to be a high incidence of fever after brain injury, with most subjects suffered a severe brain injury and had an average acute hospital length of stay ranging from 35.4 to 60 days. Expand
ROLE OF CEREBRAL INFLAMMATION AFTER TRAUMATIC BRAIN INJURY: A REVISITED CONCEPT
TLDR
The history of immunoactivation in neurotrauma is the subject of this review article, giving particular emphasis to the comparison of clinical versus experimental studies performed over the last 10 years, as well as the possible reciprocal influence of peripheral and intrathecal activation of the immune system. Expand
...
1
2
3
4
5
...