| Title: |
Brain temperature regulation in poor-grade subarachnoid hemorrhage patients – A multimodal neuromonitoring study |
| Authors: |
Addis, Alberto; Gaasch, Maxime; Schiefecker, Alois J; Kofler, Mario; Ianosi, Bogdan; Rass, Verena; Lindner, Anna; Broessner, Gregor; Beer, Ronny; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund |
| Source: |
Journal of Cerebral Blood Flow & Metabolism ; volume 41, issue 2, page 359-368 ; ISSN 0271-678X 1559-7016 |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2020 |
| Description: |
Elevated body temperature (T core ) is associated with poor outcome after subarachnoid hemorrhage (SAH). Brain temperature (T brain ) is usually higher than T core . However, the implication of this difference (T delta ) remains unclear. We aimed to study factors associated with higher T delta and its association with outcome. We included 46 SAH patients undergoing multimodal neuromonitoring, for a total of 7879 h of averaged data of T core , T brain , cerebral blood flow, cerebral perfusion pressure, intracranial pressure and cerebral metabolism (CMD). Three-months good functional outcome was defined as modified Rankin Scale ≤2. T brain was tightly correlated with T core (r = 0.948, p < 0.01), and was higher in 73.7% of neuromonitoring time (T delta +0.18°C, IQR −0.01 – 0.37°C). A higher T delta was associated with better metabolic state, indicated by lower CMD-glutamate ( p = 0.003) and CMD-lactate ( p < 0.001), and lower risk of mitochondrial dysfunction (MD) (OR = 0.2, p < 0.001). During MD, T delta was significantly lower (0°C, IQR −0.2 – 0.1; p < 0.001). A higher T delta was associated with improved outcome (OR = 7.7, p = 0.002). Our study suggests that T brain is associated with brain metabolic activity and exceeds T core when mitochondrial function is preserved. Further studies are needed to understand how T delta may serve as a surrogate marker for brain function and predict clinical course and outcome after SAH. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/0271678x20910405 |
| DOI: |
10.1177/0271678X20910405 |
| Availability: |
https://doi.org/10.1177/0271678x20910405; https://journals.sagepub.com/doi/pdf/10.1177/0271678X20910405; https://journals.sagepub.com/doi/full-xml/10.1177/0271678X20910405 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.43FF3058 |
| Database: |
BASE |