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Review Article   

Journal of Neurosurgical Sciences 2022 Mar 17

DOI: 10.23736/S0390-5616.21.05519-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Difference between brain temperature and core temperature in severe traumatic brain injury: a systematic review

Harry J. KENDALL 1 , Sander M. van KUIJK 2, Iwan C. van der HORST 3, 4, Jim T. DINGS 5, Marcel J. ARIES 3, Roel H. HAEREN 5

1 Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; 2 KEMTA, Maastricht University Medical Center+, Maastricht, the Netherlands; 3 School of Mental Health and Neurosciences, Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht University, Maastricht, the Netherlands; 4 Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; 5 School of Mental Health and Neurosciences, Department of Neurosurgery, Maastricht University Medical Center+, Maastricht University, Maastricht, the Netherlands



INTRODUCTION: Intensive care management for TBI patients aims to prevent secondary cerebral damage. Targeted temperature management is one option to prevent cerebral damage, as hypothermia may have protective effects. By conducting a systematic literature review, we evaluated (1) the presence of a temperature difference (gradient) between brain temperature (Tb) and core temperature (Tc) in TBI patients and (2) clinical factors associated with reported differences.
EVIDENCE ACQUISITION: The PubMed database was systematically searched using MESH terms and keywords, and Web of Sciences was assessed for additional article citations. We included studies that continuously and simultaneously measured Tb and Tc in severe TBI patients. The National Institutes of Health (NIH) quality assessment tool for observational cohort and cross-sectional studies was modified to fit the purpose of our study. Statistical data were extracted for further meta-analyses.
EVIDENCE SYNTHESIS: We included 16 studies, with a total of 480 patients. Clinical heterogeneity consisted of Tb/Tc measurement site, measurement device, physiological changes, local protocols, and medical or surgical interventions. The studies have a high statistical heterogeneity (I2). The pooled mean temperature gradient between Tb and Tc was +0.14 °C (95% confidence interval: 0.03 to 0.24) and ranged from -1.29 to +1.1 °C. Patients who underwent a decompressive (hemi)craniectomy showed lower Tb values compared to Tc found in three studies.
CONCLUSIONS: Studies on Tb and Tc are heterogeneous and show that, on average, Tb and Tc are not clinically significant different in TBI patients (<0.2 C). Interpretations and interventions of the brain and central temperatures will benefit from standardisation of temperature measurements.


KEY WORDS: Body temperature; Brain temperature; Adults; Humans

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