Management of Hyperthermia in Traumatic Brain Injury Patients

Abstract

Hyperthermia is frequently seen in patients following head injury. It is associated with worse outcomes in the form of longer intensive care unit stay, increased intracranial pressure and lower Glasgow Coma Scale Scores. Therefore, maintaining normal body temperature is important in these patients. This study was aimed to determine the current practices of management of hyperthermia in traumatic brain injury patients. A retrospective study was conducted on 30 traumatic brain injury patients with temperature ≥ 38 °C in the neurology wards of a tertiary care hospital in India. Demographic profile sheet and temperature recording sheet were used to record temperature and its management accordingly. The findings revealed that the highest mean temperature was recorded in patients with subdural hematoma (38.3 °C). Different modalities of management for hyperthermia being used included cold sponging, oral paracetamol and intravenous paracetamol. While no intervention was initiated at a temperature of 38 °C, cold sponging was initiated at a mean temperature of 38.2 °C. Oral paracetamol was administered at a mean temperature of 38.3 °C and the most frequently used intervention was intravenous paracetamol which was given at the mean temperature of 38.7 °C. Monitoring of temperature plays an important role in examining the effects of interventions to manage fever. It is important to have a clear definition of fever in these patients so that interventions can be initiated early.

Keywords: Traumatic Brain Injury, Hyperthermia, Oral Paracetamol