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 and central nervous system injury.
Thermoregulation in brain injury.
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.
Current trends in neurotrauma care
  • S. Timmons
  • Medicine, Psychology
    Critical care medicine
  • 2010
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.
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.
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.
The effect of hypothermia and hyperthermia on acute brain injury.
  • L. Mcilvoy
  • Biology, Medicine
    AACN clinical issues
  • 2005
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.
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.
Neurogenic Fever
TLDR
This review focuses on the detrimental effects of fever on the neurologically injured as well as the risk factors and diagnosis of neurogenic fever.
Predictive value of hyperthermia and intracranial hypertension on neurological outcomes in patients with severe traumatic brain injury
TLDR
Hyperthermia combined with ICH were shown to be significant prognostic indicators of future poor neurologic outcomes in patients with severe traumatic brain injury.
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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.
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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.
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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.
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Temperature-dependent alterations in PMNL accumulation appear to be a potential mechanism by which posttraumatic temperature manipulations may influence traumatic outcome.
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