Management of hyperthermia in traumatic brain injury.
Management of hyperthermia in traumatic brain injury.
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DOI：
10.1097/00075198-200204000-00003
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发表时间：
2002-04-01
影响因子：
3.3
通讯作者：
Andrews, Peter J D
中科院分区：
文献类型：
--
作者：
Cairns, Chris J S;Andrews, Peter J D
近年来，人们对使用低温治疗脑损伤患者及其对预后的影响非常感兴趣。大多数研究都是将37摄氏度的体温与低体温的使用进行比较，并没有证明在治疗组中有好处，但是在脑损伤患者中，低体温是什么呢？良好的流行病学证据表明，绝大多数入住ICU的患者会出现发烧。发热的发展显然与较差的预后有关。现在对发烧的可能危害机制和降温的副作用有了更好的了解。讨论了几种控制温度的处理方案。尽管控制脑损伤患者的发热有良好的生理学依据，但没有证据表明这样做会改善结果。
Recently there has been much interest in the use of hypothermia in the management of the brain-injured patient and its effect on outcome. Most of these studies examine the use of hypothermia compared with normothermia of 37 degrees C and have failed to demonstrate a benefit in the treatment groups, but what is normothermia in the brain-injured patient? Good epidemiologic evidence suggests that the vast majority of patients admitted to an ICU environment will develop a fever. The development of fever is clearly associated with a worse prognosis. There is now a better understanding of the possible mechanism of harm of fever and the side effects of cooling. Several treatment options for controlling temperature are discussed. Despite a sound physiologic argument for controlling fever in the brain-injured patient, there is no evidence that doing so will improve outcome.