engleski

Brain on fire-managing normothermia in neurosurgical patients-therapeutic options

Fever in the neurocritical care is common and it has negative impact on mortality and morbidity. Only ½ cases are infectious (nosocomial pulmonary infections) and in 1/3 to 1/5 cases is unexplained (central fever). Brain temperature can be up to 2 °higher than peripheral body temperature. Therapeutic hypothermia (TH) failed to demonstrate a decrease in mortality and unfavorable clinical outcome at 3 or 6 months post-TBI. Additionally, TH might increase the risk of developing pneumonia and cardiovascular complications. So normothermia is a therapeutic goal. Managing normothermia can be challenging in neurosurgical patients. Pharmacological resistance is common. Central fever diagnosis is made by exclusion of other causes. Esophageal cooling devices (ECD) can offer a safe and effective adjunct in managing refractory fever. Shivering assessment and treatment is mandatory!!!

fever, brain temperature ; Therapeutic hypothermia, Normothermia ; brain injury

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