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A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
A multicentre audit of temperature patterns after traumatic brain injury
Manoj K Saxena1, Colman Taylor2, Naomi Hammond2
1Department of Intensive Care Medicine, St George Hospital, Sydney, NSW, Australia. m.saxena@unsw.edu.au.
Background:
Elevation of body temperature is common after traumatic brain injury (TBI). Suppressing fever may be beneficial.
Hypothesis:
In clinical practice, temperature is maintained _37°C.
Participants, Setting And Methods:
A retrospective, multicentre, cohort study of patients with an intensive care unit admission diagnosis of TBI over a 6-month period.
Main Outcome Measures:
The mean proportion of time per day that temperature _37°C or _38°C (to correct for unequal measurements between patients, imputation was used between consecutive temperature measurements and a linear relationship was assumed); and the proportion of patients on each day with a peak temperature _37°C.
Results:
217 patients with TBI were admitted to eight ICUs. The mean Acute Physiology and Chronic Health Evaluation II score of the cohort was 15.7 (SD, 7.7) and intracranial pressure monitoring was done in 29% of patients. The mean proportion of time on each day that temperature was _37°C varied between 56% (SE, 2.6%) on Day 1 and 89% (SE, 3.7%) on Day 14. The mean proportion of time per day that temperature was > 38°C was between a minimum of 11% (SE, 1.5%) on Day 1 and a maximum of 25% (SE, 4.4%) Day 11. The proportion of patients for whom daily peak temperature was > 37°C ranged between a minimum of 73.2% (153/209) on Day 1 and a maximum of 97.4% (26/33) on Day 13.
Conclusion:
In patients with TBI, a substantial proportion of time is spent with a temperature _37°C. Prospective validation of these data are required.
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