| Induced normothermia attenuates intracranial hypertension and reduces fever burden after severe traumatic brain injury. | |
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MedLine Citation:
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PMID: 19337864 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Hyperthermia 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. METHODS: A comparative cohort study of 21 adult patients with severe TBI (GCS <or= 8) treated with induced normothermia [36-36.5 degrees C rectal probe setting; intravascular cooling catheter (CoolLine, Alsius Corporation, Irvine, CA)] were matched by age, gender, and severity of injury to 21 historical control severe TBI patients treated with conventional fever control methods. ICP was measured via an external ventricular catheter and time duration for ICP > 25 mmHg was calculated for the initial 72-h monitoring period. Non-parametric rank tests were performed. RESULTS: Mean (+/-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). CONCLUSION: Induced 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. |
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Authors:
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Ava M Puccio; Michael R Fischer; Brian T Jankowitz; Howard Yonas; Joseph M Darby; David O Okonkwo |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-04-01 |
Journal Detail:
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Title: Neurocritical care Volume: 11 ISSN: 1541-6933 ISO Abbreviation: Neurocrit Care Publication Date: 2009 |
Date Detail:
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Created Date: 2009-07-07 Completed Date: 2009-09-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 82-7 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, B-400 PUH, Pittsburgh, PA 15213, USA. puccioam@upmc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Body Temperature Brain Injuries / therapy* Case-Control Studies Critical Care / methods Female Fever / therapy* Humans Hypothermia, Induced / methods* Intracranial Hypertension / therapy* Male Middle Aged Severity of Illness Index Treatment Outcome Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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NS30318/NS/NINDS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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