Oshorov A V, Polupan A A, Sychev A A, Baranich A I, Kurdyumova N V, Abramov T A, Savin I A, Potapov A A
Burdenko Neurosurgical Center, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2021;85(1):68-77. doi: 10.17116/neiro20218501168.
Background. Hyperthermia is a common symptom in ICU patients with brain injury.
To study the effect of hyperthermia on intracranial pressure (ICP) and cerebral autoregulation (Prx).
There were 8 patients with acute brain injury, signs of brain edema and intracranial hypertension. Cerebral autoregulation was assessed by using of PRx. ICP, CPP, BP, PRx were measured before and during hyperthermia. We have analyzed 33 episodes of cerebral hyperthermia over 38.30 C. Statistica 10.0 (StatSoft) was used for statistical analysis.
Only ICP was significantly increased by 6 [3; 11] mm Hg (<0.01). In patients with initially normal ICP, hyperthermia resulted increase of ICP in 48% of cases (median 24 [22; 28] mm Hg). In patients with baseline intracranial hypertension, progression of hypertension was noted in 100% cases (median 31 [27; 32] mm Hg) (<0.01). Hyperthermia resulted intracranial hypertension regardless brain autoregulation status.
Cerebral hyperthermia in patients with initially normal ICP results intracranial hypertension in 48% of cases. In case of elevated ICP, further progression of intracranial hypertension occurs in 100% of cases. Cerebral hyperthermia is followed by ICP elevation in both intact and impaired cerebral autoregulation.
背景。体温过高是脑损伤重症监护病房患者的常见症状。
研究体温过高对颅内压（ICP）和脑自动调节（Prx）的影响。
有8例急性脑损伤、脑水肿和颅内高压体征的患者。通过使用PRx评估脑自动调节。在体温过高之前和期间测量ICP、CPP、BP、PRx。我们分析了38.30℃以上的33次脑体温过高发作。使用Statistica 10.0（StatSoft）进行统计分析。
仅ICP显著升高6[3；11]mmHg（<0.01）。在初始ICP正常的患者中，体温过高导致48%的病例ICP升高（中位数24[22；28]mmHg）。在基线颅内高压患者中，100%的病例出现高血压进展（中位数31[27；32]mmHg）（<0.01）。无论脑自动调节状态如何，体温过高都会导致颅内高压。
初始ICP正常的患者中，脑体温过高导致48%的病例出现颅内高压。在ICP升高的情况下，100%的病例会出现颅内高压的进一步进展。在完整和受损的脑自动调节情况下，脑体温过高都会导致ICP升高。
