Body temperature management after severe traumatic brain injury: Methods and protocols used in the United Kingdom and Ireland

Nicola J. Johnston, Andrew T. King, Richard Protheroe, Charmaine Childs

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective: To establish whether there is consensus in the management of body temperature in patients with severe traumatic brain injury (TBI) admitted to hospitals in the United Kingdom and Ireland for neurosurgical intensive care. Methods: Permission was granted from the Society of British Neurosurgeons (SBNS) and the Local Research Ethics Committee to undertake the survey. A senior member of nursing staff from all adult neurosurgical units, excluding our own, was contacted by telephone. Results: All 33 adult neurosurgical centres participated. Six units had a formal written protocol for the management of body temperature. For the remainder (27 units), interest was expressed in a protocol for temperature management particularly for those patients with intractable hyperthermia/fever. Administration of the antipyretic paracetamol was the most common 'first-line' treatment (13 units). Other 'first-line' methods were: circulating air-cooling blankets (9 units), water-filled cooling blankets (6 units), tepid sponging or wet soaks (2 units), convection fans (2 units) and administration of cold fluids via the gut or circulation (1 unit). When 'first-line' methods failed to bring about a fall in temperature, different combinations of these methods were used. Conclusions: From this survey, it is evident that there is no consensus in the approach to temperature management in neurosurgical intensive care patients with severe TBI. Review and rationalisation of systems of care may be required in an effort to develop evidence-based nationwide guidelines. © 2006 Elsevier Ireland Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)254-262
    Number of pages8
    JournalResuscitation
    Volume70
    Issue number2
    DOIs
    Publication statusPublished - Aug 2006

    Keywords

    • Brain injury
    • Intensive care
    • Temperature

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