The impact of brain temperature and core temperature on intracranial pressure and cerebral perfusion pressure.
Hyperthermia has been demonstrated to increase neuronal injury when present during or after an acute brain injury. The assumption that core temperature equals brain temperature exists. If the temperature of an injured brain is higher than core temperature, episodes of neural hyperthermia may go undetected. The objectives of this study were to (1) determine if differences exist between brain temperature and core temperature in subjects with acute neurological injuries in both normothermic and febrile states and (2) investigate the impact of brain and core temperatures on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). The study was conducted through a retrospective chart audit of patients age 18 years or older admitted to a level I trauma center with a diagnosis of brain injury whose condition warranted placement of a pulmonary artery catheter (which measured core temperature) and an intraventricular catheter (which measured brain temperature). Thirty-one charts contained complete data; nine charts provided partial data. Mean brain temperature (100.8 degrees F, SD = 0.69) was found to be significantly higher than mean core temperature (100.2 degrees F, SD = 0.74; p = .00). Brain temperature means were hyperthermic (> or = 100.9 degrees F), while matching core temperatures were normothermic in almost one-third of the subjects. There was no significant difference found between hyperthermic ICP or CPP and normothermic ICP or CPP determined by brain or core temperature. No significant correlation was found between temperature and intracranial dynamics. Future research is needed with prospectively collected data of adequate sample size to continue to investigate the impact of core and brain temperature on the intracranial dynamics of ICP and CPP.
Mcilvoy
Laura
L
Division of Nursing, Indiana University Southeast, New Albany, IN, USA. lmcilvoy@att.net
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D005334:Fever / Q000503:physiopathology*; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies