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3 - Disorders of Temperature Regulation

Published online by Cambridge University Press:  19 May 2022

Andrew M. Naidech
Affiliation:
Northwestern University, Illinois
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Summary

As the first vital sign, temperature occupies a prominent place in the initial assessment of a patient and is of particular significance in an acutely ill patient in the neurocritical care unit. Its interpretation, measurement, and clinical significance can be confounded by the disruption of the normal thermoregulatory mechanisms of the central nervous system, as well as various pharmacotherapies. This chapter aims to provide the reader with an overview of the clinical approach to fever in the neurocritical care unit. This will encompass a discussion of the common causes of fever, including serotonin syndrome, neuroleptic malignant syndrome, malignant hyperthermia, and paroxysmal sympathetic hyperreactivity. Finally, we describe how temperature can be leveraged as an evidence-based therapeutic tool to help improve neurologic outcomes after cardiac arrest.

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Chapter
Information
Neurocritical Care , pp. 32 - 64
Publisher: Cambridge University Press
Print publication year: 2022

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References

O’Grady, NP, Barie, PS, Bartlett, JG, et al. Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America. Crit Care Med. 2008;36:1330.Google Scholar
Benarroch, E. Thermoregulation: recent concepts and remaining questions. Neurology. 2007;69:1293–97.CrossRefGoogle ScholarPubMed
Dunkley, EJC, Isbister, GK, Sibbritt, D, et al. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM-Int J Med. September 2003;96(9):635–42.CrossRefGoogle ScholarPubMed
Baguley, IJ, Perkes, IE, Fernández-Ortega, JF, et al. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma. 2014;31:1515–20.CrossRefGoogle ScholarPubMed
Meyfroidt, G, Baguley, IJ, Menon, DK. Paroxysmal sympathetic hyperactivity: the storm after acute brain injury. The Lancet Neurol. 2017;16(9):721–29.CrossRefGoogle ScholarPubMed
The Hypothermia After Cardiac Arrest (HACA) Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346:549–56.Google Scholar
Bernard, SA, Gray, TW, Buist, MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002;346:557–63.CrossRefGoogle ScholarPubMed
Nielsen, N, Wetterslev, J, Cronberg, T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med. December 5, 2013;369(23):2197–206.CrossRefGoogle ScholarPubMed
Bray, JE, Stub, D, Bloom, JE, et al. Changing target temperature from 33°C to 36°C in the ICU management of out-of-hospital cardiac arrest: a before and after study. Resuscitation. 2017;113:3943.CrossRefGoogle ScholarPubMed
Johnson, NJ, Danielson, KR, Counts, CR, et al. Targeted temperature management at 33 versus 36 degrees: a retrospective cohort study. Crit Care Med. 2020;48:362369.Google Scholar
Kirkegaard, H, Søreide, E, de Haas, I, et al. Targeted temperature management for 48 vs 24 hours and neurologic outcome after out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2017;318:341–50.CrossRefGoogle ScholarPubMed
Stær-Jensen, H, Sunde, K, Olasveengen, TM, et al. Bradycardia during therapeutic hypothermia is associated with good neurologic outcome in comatose survivors of out-of-hospital cardiac arrest. Crit Care Med. November 2014;42(11):2401–08.CrossRefGoogle ScholarPubMed
Andrews, PJ, Sinclair, HL, Rodriguez, A, et al. Hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med. 2015;373:2403.Google Scholar
Legriel, S, Lemiale, V, Schenck, M, et al. Hypothermia for neuroprotection in convulsive status epilepticus. N Engl J Med. 2016;375:2457.CrossRefGoogle ScholarPubMed
Vaity, C, Al-Subaie, N, Cecconi, M. Cooling techniques for targeted temperature management post-cardiac arrest. Crit Care. 2015;19:103.CrossRefGoogle ScholarPubMed

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