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Clinical review: Brain-body temperature differences in adults with severe traumatic brain injury.

Childs C, Lunn KW - Crit Care (2013)

Bottom Line: Articles published in English from the years 1980 to 2012 were searched in databases, CINAHL, PubMed, Scopus, Web of Science, Science Direct, Ovid SP, Mednar and ProQuest Dissertations & Theses Database.Eleven studies were included in the systematic review providing 15 brain-core body temperature comparisons.Hypothermia is associated with large brain-body temperature differences.

View Article: PubMed Central - HTML - PubMed

ABSTRACT
Surrogate or 'proxy' measures of brain temperature are used in the routine management of patients with brain damage. The prevailing view is that the brain is 'hotter' than the body. The polarity and magnitude of temperature differences between brain and body, however, remains unclear after severe traumatic brain injury (TBI). The focus of this systematic review is on the adult patient admitted to intensive/neurocritical care with a diagnosis of severe TBI (Glasgow Coma Scale score of less than 8). The review considered studies that measured brain temperature and core body temperature. Articles published in English from the years 1980 to 2012 were searched in databases, CINAHL, PubMed, Scopus, Web of Science, Science Direct, Ovid SP, Mednar and ProQuest Dissertations & Theses Database. For the review, publications of randomised controlled trials, non-randomised controlled trials, before and after studies, cohort studies, case-control studies and descriptive studies were considered for inclusion. Of 2,391 records identified via the search strategies, 37 were retrieved for detailed examination (including two via hand searching). Fifteen were reviewed and assessed for methodological quality. Eleven studies were included in the systematic review providing 15 brain-core body temperature comparisons. The direction of mean brain-body temperature differences was positive (brain higher than body temperature) and negative (brain lower than body temperature). Hypothermia is associated with large brain-body temperature differences. Brain temperature cannot be predicted reliably from core body temperature. Concurrent monitoring of brain and body temperature is recommended in patients where risk of temperature-related neuronal damage is a cause for clinical concern and when deliberate induction of below-normal body temperature is instituted.

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Related in: MedlinePlus

Appraisal tool. A modification of the appraisal tool of Craig and colleagues [10] was developed and approved.
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Related In: Results  -  Collection


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Figure 1: Appraisal tool. A modification of the appraisal tool of Craig and colleagues [10] was developed and approved.

Mentions: The publications selected for retrieval were assessed for methodological validity by two independent reviewers (CC and KWL) before data extraction. The JBI-MAStARI critical appraisal tool was used. However, in view of the specific review question, neither the standard nor bespoke appraisal tools available (the latter for temperature method comparison [10]) from JBI were appropriate. In this review, where measurement of temperature per se at two different body sites was made predominately by electronic thermometry systems, a modification of the appraisal tool of Craig and colleagues [10] was developed and approved (Figure 1) by the JBI [8]. As there were no disagreements in the assessment of methodological quality of the retrieved studies, a third, moderator, reviewer was not required.


Clinical review: Brain-body temperature differences in adults with severe traumatic brain injury.

Childs C, Lunn KW - Crit Care (2013)

Appraisal tool. A modification of the appraisal tool of Craig and colleagues [10] was developed and approved.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672533&req=5

Figure 1: Appraisal tool. A modification of the appraisal tool of Craig and colleagues [10] was developed and approved.
Mentions: The publications selected for retrieval were assessed for methodological validity by two independent reviewers (CC and KWL) before data extraction. The JBI-MAStARI critical appraisal tool was used. However, in view of the specific review question, neither the standard nor bespoke appraisal tools available (the latter for temperature method comparison [10]) from JBI were appropriate. In this review, where measurement of temperature per se at two different body sites was made predominately by electronic thermometry systems, a modification of the appraisal tool of Craig and colleagues [10] was developed and approved (Figure 1) by the JBI [8]. As there were no disagreements in the assessment of methodological quality of the retrieved studies, a third, moderator, reviewer was not required.

Bottom Line: Articles published in English from the years 1980 to 2012 were searched in databases, CINAHL, PubMed, Scopus, Web of Science, Science Direct, Ovid SP, Mednar and ProQuest Dissertations & Theses Database.Eleven studies were included in the systematic review providing 15 brain-core body temperature comparisons.Hypothermia is associated with large brain-body temperature differences.

View Article: PubMed Central - HTML - PubMed

ABSTRACT
Surrogate or 'proxy' measures of brain temperature are used in the routine management of patients with brain damage. The prevailing view is that the brain is 'hotter' than the body. The polarity and magnitude of temperature differences between brain and body, however, remains unclear after severe traumatic brain injury (TBI). The focus of this systematic review is on the adult patient admitted to intensive/neurocritical care with a diagnosis of severe TBI (Glasgow Coma Scale score of less than 8). The review considered studies that measured brain temperature and core body temperature. Articles published in English from the years 1980 to 2012 were searched in databases, CINAHL, PubMed, Scopus, Web of Science, Science Direct, Ovid SP, Mednar and ProQuest Dissertations & Theses Database. For the review, publications of randomised controlled trials, non-randomised controlled trials, before and after studies, cohort studies, case-control studies and descriptive studies were considered for inclusion. Of 2,391 records identified via the search strategies, 37 were retrieved for detailed examination (including two via hand searching). Fifteen were reviewed and assessed for methodological quality. Eleven studies were included in the systematic review providing 15 brain-core body temperature comparisons. The direction of mean brain-body temperature differences was positive (brain higher than body temperature) and negative (brain lower than body temperature). Hypothermia is associated with large brain-body temperature differences. Brain temperature cannot be predicted reliably from core body temperature. Concurrent monitoring of brain and body temperature is recommended in patients where risk of temperature-related neuronal damage is a cause for clinical concern and when deliberate induction of below-normal body temperature is instituted.

Show MeSH
Related in: MedlinePlus