Abstract
Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe TBI. This prospective controlled study was conducted on 50 severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission. Then, they were randomly assigned into 2 groups. Bromocriptine group (25) received bromocriptine 7.5 mg/day during 24 hours from admission through a naso-gastric (NG) feeding tube. Control group (25) received conventional treatment only. Temperature was measured every 2 hours. The antipyretic measures used were the same across all patients enrolled. The primary outcome was number of patients diagnosed with central hyperthermia. After the discharge of all patients, there was a statistically significant difference between the 2 groups in number of patients diagnosed with central hyperthermia (6 (24%) in bromocriptine group Vs 18 (72%) in control, p = 0.002). There were no differences in hospital length of stay (p = 0.904) or mortality (p = 0.393). Early administration of bromocriptine in severe TBI may be associated with lower incidence of central hyperthermia with no effect on length of stay or mortality.
Highlights
This prospective controlled study was conducted on 50 severe Traumatic brain injury (TBI) patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and Glasgow coma score (GCS) of less than 9 at admission
After ethical approval for this clinical trial from the local committee of ethics in the faculty of medicine of Alexandria University and the department of critical care, informed consent was taken from the of kin. This prospective controlled study was conducted on severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission
In our trial we studied the relation between early bromocriptine administration after severe traumatic brain injury and the incidence of central hyperthermia
Summary
Traumatic brain injury (TBI) is structural injury and/or physiologic disruption of brain function from blunt trauma, acceleration or deceleration forces, or ex-. Sabry posure to blast [1]. Severe TBI is usually defined with a Glasgow coma score (GCS) of ≤8 within the first two days following trauma [2]. Hyperthermia is a common symptom among critically ill patients. Hyperthermia is more related to infectious diseases [3] [4]. Hyperthermia after TBI is associated with poor diagnosis [6] [7]. It is associated with marked fluctuations in body temperature and a rapid response [8]
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