Temperature variability in the day–night cycle is associated with further intracranial pressure during therapeutic hypothermia

Journal of Translational Medicine

Research

Adriano Barreto Nogueira¹  Oliver Boss²  Eva Annen²  Christopher Sikorski²  Emanuela Keller²  Faraneh Farokhzad² 

[1] Division of Neurosurgery Clinic, Hospital das Clínicas, Faculty of Medicine, University of Sao Paulo, 255 Dr. Eneas de Carvalho Aguiar Ave, 05403-900, Sao Paulo, Brazil;Neurocritical Care Unit, Department of Neurosurgery, University Hospital, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland;Neurocritical Care Unit, Department of Neurosurgery, University Hospital, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland;

关键词: Intracranial pressure;    Hypothermia;    Circadian rhythm;    Temperature;    Prediction;    Multimodality monitoring;   

DOI  :  10.1186/s12967-017-1272-y

 received in 2016-12-15, accepted in 2017-07-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTo assess whether circadian patterns of temperature correlate with further values of intracranial pressure (ICP) in severe brain injury treated with hypothermia.MethodsWe retrospectively analyzed temperature values in subarachnoid hemorrhage patients treated with hypothermia by endovascular cooling. The circadian patterns of temperature were correlated with the mean ICP across the following day (ICP24).ResultsWe analyzed data from 17 days of monitoring of three subarachnoid hemorrhage patients that underwent aneurysm coiling, sedation and hypothermia due to refractory intracranial hypertension and/or cerebral vasospasm. ICP24 ranged from 11.5 ± 3.1 to 24.2 ± 6.2 mmHg. The ratio between the coefficient of variation of temperature during the nocturnal period (18:00–6:00) and the preceding diurnal period (6:00–18:00) [temperature variability (TV)] ranged from 0.274 to 1.97. Regression analysis showed that TV correlated with ICP24 (Pearson correlation = −0.861, adjusted R square = 0.725, p < 0.001), and that ICP24 = 6 (4–TV) mmHg or, for 80% prediction interval, ICP24=23.9-6.22×TV±1.73×1.06+((TV-1.1)2/4.49)\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$${\text{ICP}}_{24} = 23.9 - 6.22\,\times\,{\text{TV }} \pm 1.73\,\times\sqrt {1.06 + (({\text{TV}} - 1.1)^{2} /4.49)}$$\end{document} mmHg. The results indicate that the occurrence of ICP24 higher than 20 mmHg is unlikely after a day with TV ≥1.0.ConclusionsTV correlates with further ICP during hypothermia regardless the strict range that temperature is maintained. Further studies with larger series could clarify whether intracranial hypertension in severe brain injury can be predicted by analysis of oscillation patterns of autonomic parameters across a period of 24 h or its harmonics.

【 授权许可】

CC BY   
© The Author(s) 2017

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