Trial reportNeurocritical care2008
A prospective, observational clinical trial of fever reduction to reduce systemic oxygen consumption in the setting of acute brain injury.
Trial report in Neurocritical care, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The Implementation of Targeted Temperature Management: An Evidence-Based Guideline from the Neurocritical Care Society.Neurocritical care · 2017Pooled it
- The role of neuromuscular blockade in patients with traumatic brain injury: a systematic review.Neurocritical care · 2015Pooled it
- Pooled it
- Consensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care : a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.Intensive care medicine · 2014Guideline
- Clinical Management in Traumatic Brain Injury.Biomedicines · 2024Review
- Minimizing Shivering During Targeted Normothermia: Comparison Between Novel Transnasal and Surface Temperature-Modulating Devices.Neurocritical care · 2023Article
- Safety and Feasibility of a Novel Transnasal Cooling Device to Induce Normothermia in Febrile Cerebrovascular Patients.Neurocritical care · 2021Article
- Esophageal Cooling Device Versus Other Temperature Modulation Devices for Therapeutic Normothermia in Subarachnoid and Intracranial Hemorrhage.Therapeutic hypothermia and temperature management · 2018Article
- Monitoring inflammation (including fever) in acute brain injury.Neurocritical care · 2014Review
- [News and perspectives in neurocritical care].Der Nervenarzt · 2014Review
- Fever management in SAH.Neurocritical care · 2011Review
- Acetaminophen has limited antipyretic activity in critically ill patients.Journal of critical care · 2010Article
- Effect of shivering on brain tissue oxygenation during induced normothermia in patients with severe brain injury.Neurocritical care · 2010Article
- Management of intracranial pressure.Current neurology and neuroscience reports · 2009Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFever after acute brain injury appears to be a detrimental factor, associated with impaired neurological outcomes. This study assessed physiological changes in systemic oxygen consumption (VO2) during cutaneous cooling after severe brain injury.
methodsThis prospective, observational, clinical study evaluated ten, critically ill, brain-injured patients requiring mechanical ventilation with a core body temperature of greater or equal to 38 degrees C. Febrile patients failing to defervesce after acetaminophen underwent indirect calorimetry for a 1-hour baseline period followed by a 4 h cooling period. The Arctic Sun(R) Temperature Management System (Medivance) directed core temperature to a goal of 36 degrees C.
resultsThe patients had a mean age of 32 years (95% CI 23, 40), Glasgow Coma Scale of 6 (95% CI 5,7), and APACHE 2 score of 19 (95% CI 15, 22), with 8 of 10 patients suffering traumatic brain injuries. The baseline 1-h core temperature was significantly reduced from 38.6 degrees +/- 0.9 to 36.3 degrees +/- 1.2 degrees C (P < 0.0001) over 4 h. Two cohorts were identified based upon the presence or absence of shivering. Within the non-shivering cohort, systemic VO2 was significantly reduced from 415 +/- 123 to 308 +/- 115 ml/min (-27 +/- 18%) (P < 0.05). In contrast, those with shivering showed no significant reduction in VO2, despite significantly decreasing core temperature. The overall percentage change of VCO2 correlated with VO2 (r (2) = 0.91).
conclusionFever reduction in acute brain injury appears to significantly reduce systemic VO2, but is highly dependent on shivering control.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.