Fever management in acute brain injury

Bogossian, Elisa Gouvêa; Taccone, Fabio Silvio

doi:10.1097/mcc.0000000000000918

Cited by 5 publications

(6 citation statements)

References 83 publications

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“…Furthermore, excessive body temperature, leading to altered temperature rhythms in patients with poor-grade aSAH, may be a contributing factor. Recently, targeted temperature management (TTM), a treatment strategy for critically ill patients, has been proposed to reduce the secondary neurological damage of poor-grade aSAH ( 37 , 38 ). Temperature changes contribute to prediction of patient prognosis, particularly in patients with refractory fever.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting the risk of poor prognosis in patients with poor-grade aneurysmal subarachnoid hemorrhage following microsurgical clipping

Zhou

Liu²,

Yang³

et al. 2023

Front. Neurol.

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ObjectiveAneurysmal subarachnoid hemorrhage (aSAH) is a common and potentially fatal cerebrovascular disease. Poor-grade aSAH (Hunt-Hess grades IV and V) accounts for 20–30% of patients with aSAH, with most patients having a poor prognosis. This study aimed to develop a stable nomogram model for predicting adverse outcomes at 6 months in patients with aSAH, and thus, aid in improving the prognosis.MethodThe clinical data and imaging findings of 150 patients with poor-grade aSAH treated with microsurgical clipping of intracranial aneurysms on admission from December 2015 to October 2021 were retrospectively analyzed. Least absolute shrinkage and selection operator (LASSO), logistic regression analyses, and a nomogram were used to develop the prognostic models. Receiver operating characteristic (ROC) curves and Hosmer–Lemeshow tests were used to assess discrimination and calibration. The bootstrap method (1,000 repetitions) was used for internal validation. Decision curve analysis (DCA) was performed to evaluate the clinical validity of the nomogram model.ResultLASSO regression analysis showed that age, Hunt-Hess grade, Glasgow Coma Scale (GCS), aneurysm size, and refractory hyperpyrexia were potential predictors for poor-grade aSAH. Logistic regression analyses revealed that age (OR: 1.107, 95% CI: 1.056–1.116, P < 0.001), Hunt-Hess grade (OR: 8.832, 95% CI: 2.312–33.736, P = 0.001), aneurysm size (OR: 6.871, 95% CI: 1.907–24.754, P = 0.003) and refractory fever (OR: 3.610, 95% CI: 1.301–10.018, P < 0.001) were independent predictors of poor outcome. The area under the ROC curve (AUC) was 0.909. The calibration curve and Hosmer–Lemeshow tests showed that the nomogram had good calibration ability. Furthermore, the DCA curve showed better clinical utilization of the nomogram.ConclusionThis study provides a reliable and valuable nomogram that can accurately predict the risk of poor prognosis in patients with poor-grade aSAH after microsurgical clipping. This tool is easy to use and can help physicians make appropriate clinical decisions to significantly improve patient prognosis.

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Section: Discussionmentioning

confidence: 99%

A nomogram for predicting the risk of poor prognosis in patients with poor-grade aneurysmal subarachnoid hemorrhage following microsurgical clipping

Zhou

Liu²,

Yang³

et al. 2023

Front. Neurol.

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“…Однако результаты выполненного моделирования будут верны только в том случае, если наличие ВЧК не приведет к умиранию по гипертермическому типу. Такой вариант танатогенеза возможен, поскольку лихорадка является нередким осложнением оболочечных кровоизлияний [7,[9][10][11]…”

Section: Discussionunclassified

Finite element analysis of the effect of intracranial hemorrhages on postmortem cranioencephalic temperature

Nedugov

2022

Tihookeanskij medicinskij žurnal

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Aim. To assess the local influence of intracranial hemorrhages of various types on postmortem cranioencephalic temperature by means of finite element modeling of the postmortem temperature field of the head.Methods. The geometry and postmortem heat exchange of human head anatomical structures were simulated using the ELCUT 6.5 software application based on the finite element method, both in the absence and presence of meningeal and intraventricular hemorrhages.Results. A twodimensional finite element model for determining the postmortem temperature field of the head in the presence of various intracranial hemorrhages under the conditions of convective heat exchange with the air was developed. The absence of a significant direct effect of intracranial hemorrhages on cranioencephalic temperature was confirmed.Conclusions. Cranioencephalic temperature can be used to determine the postmortem interval in the presence of any intracranial hemorrhages. In order to exclude errors associated with possible hyperthermic death, as well as those caused by local exposure to intraventricular hemorrhages, cranioencephalic temperature should be used to determine the postmortem interval only after its reduction to values lower than 36 °C.

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“…Author details 1 Department of Intensive Care, Hôpital Universitare de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium. 2 Department of Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Gynaecology and Paediatrics, University of Verona, AOUI-University Hospital Integrated Trust of Verona, Policlinico G.B.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…Body temperature regulation, which is tightly controlled by several mechanisms in healthy individuals, is often altered after an acute brain injury (ABI) because of either non-infectious (i.e. tissue damage, systemic or cerebral inflammation, vascular injury, hemorrhagic lesions, deep venous thrombosis) and/or infectious causes [1]. As such, ABI patients often experience fever (variously defined as a body temperature exceeding 37.5 to 38.5 °C), regardless of the type of brain disease and site of temperature measurement.…”

mentioning

confidence: 99%

Manipulating temperature: devices for targeted temperature management (TTM) in brain injury

2022

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Fever management in acute brain injury

Cited by 5 publications

References 83 publications

A nomogram for predicting the risk of poor prognosis in patients with poor-grade aneurysmal subarachnoid hemorrhage following microsurgical clipping

A nomogram for predicting the risk of poor prognosis in patients with poor-grade aneurysmal subarachnoid hemorrhage following microsurgical clipping

Finite element analysis of the effect of intracranial hemorrhages on postmortem cranioencephalic temperature

Manipulating temperature: devices for targeted temperature management (TTM) in brain injury

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