Efficacy of prophylactic enteral bromocriptine in reducing the neurogenic fever in severe traumatic brain injury patients in the trauma intensive care unit - A randomized placebo-controlled study.

Introduction: Neurogenic fever (NF) is a noninfectious, centrally mediated hyperthermia seen in patients with traumatic brain injury (TBI) and other neurological conditions. Fever exacerbates secondary brain injury, increases metabolic demand, and worsens patient outcomes. Dopamine agonists such as bromocriptine, which modulate hypothalamic thermoregulation, have been proposed as potential therapeutic agents. This study evaluates the efficacy of prophylactic bromocriptine in preventing NF in patients with severe TBI. Methods: In this randomized, double-blind, placebo-controlled trial, 100 adult patients with isolated severe TBI admitted within 24 h of injury were assigned to receive either bromocriptine (5 mg twice daily, Results: After exclusions and dropouts, 43 patients in the bromocriptine group and 45 in the placebo group were analyzed. NF incidence was lower in the bromocriptine group (41.86%) compared to placebo (55.56%), but the difference was not statistically significant ( Conclusion: Prophylactic bromocriptine did not significantly reduce NF incidence in severe TBI but showed trends toward lower fever severity. Further research with larger cohorts and optimized dosing is warranted.