Antipyretic treatment of noninfectious fever in children with severe traumatic brain injury.
OBJECTIVE
The purpose of this study was to describe the treatment of noninfectious fever in children with severe traumatic brain injury (TBI).


METHODS
We conducted a retrospective study to compare type of and response to antipyretic treatment strategies in children less than or equal to 17 years and Glasgow Coma Scale (GCS) score less than 9.


RESULTS
The average admission GCS score was 4. Forty children (35 boys, 5 girls), age 7.8 +/- 5.2 years, had noninfectious fever. Seventy percent (28 of 40) received acetaminophen only, and 30% (12 of 40) received acetaminophen plus either ibuprofen or physical cooling. Time to next febrile episode was longer in patients receiving combination therapy than those receiving monotherapy (p = 0.03). Fever refractory to treatment dose or strategy occurred in more than 40% of the patients.


CONCLUSIONS
Early combination antipyretic therapy may be needed to effectively maintain normothermia in children with severe TBI.
Brown
Jonathon M
JM
Department of Biomedical Sciences, Medical Sciences Programs, Drexel University College of Medicine, Philadelphia, PA 19104, USA.
Udomphorn
Yuthana
Y
Suz
Pilar
P
Vavilala
Monica S
MS
D000082:Acetaminophen / Q000627:therapeutic use; D000367:Age Factors; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen