Effects of Brain Temperature on the Outcome of Patients with Traumatic Brain Injury: A Prospective Observational Study

Abstract

A prospective observational study collected temperature data from 51 patients in 11 neurosurgical centers and follow-up outcome information at 6 months in 49 patients. Brain temperature (T) was measured directly by an intraventricular temperature sensor. Axillary temperature (T) and rectal temperature (T) were measured by electric thermometers. T was 0.4 to 1.5°C higher than body temperature. T correlated well with the T (coefficient: 0.7378; p < 0.05). Among all patients, Glasgow Coma Scale (GCS) scores on admission were significantly lower in the patients with post-operatively extreme peak temperature (T, < 37°C or >39°C in first 24 h) and major temperature variation (T > 1°C in first 12 h; p < 0.05, p < 0.01, respectively). Among the patients with no temperature intervention, the extreme T group showed a lower Glasgow Outcome Scale-Extended (GOS-E) score at 6 months (p < 0.05) with lower GCS scores on admission (p < 0.01), compared with the moderate T group. Remarkably, the major T group showed significantly lower GOS-E scores (p < 0.05) with the same GCS scores as the minor T group. Thus, T is the better candidate to estimate T. Spontaneously extreme T in TBI represents both more serious injury on admission and worse prognosis, and T might be used as a novel prognostic parameter in TBI. Brain temperature is therefore one of the critical indicators evaluating injury severity, prognostication, and monitoring in the management of TBI. This prospective observational study has been registered in ClinicalTrials.gov ( https://clinicaltrials.gov ), and the registration number is NCT03068143.

The Effect of Temperature Increases on Brain Tissue Oxygen Tension in Patients with Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Substudy

“…Our study suggests that alterations of temperature may negatively affect brain hemodynamics only in a minority of analyzed episodes. In a recent prospective observational study in TBI patients, brain temperature variations (>1°C) were associated with poor functional outcome (Weng et al, 2019). Similarly, a higher temperature variability within the first 48 hours was associated with poor functional outcome in the control group treated with normothermia in a post hoc analysis of the EUROTHERM trial (Abu-Arafeh et al, 2018).…”