Managing acute non-anoxic brain injuries, including hemorrhagic or
ischemic strokes and traumatic brain injuries, poses a significant challenge in
neurology. This challenge is compounded by the fact that fever, present in
nearly 90% of patients in intensive care, is closely linked to severe
neurological complications. Understanding the impact of fever on clinical
outcomes is essential to optimizing therapeutic strategies and improving the
quality of care. This study examines the connection between fever and
neurological deterioration, offering insight into targeted intervention approaches.
Fever and brain injuries: what are the measured impacts?
The analysis is based on data from over 180 trials involving a total of
460,825 patients admitted for acute brain injuries. Key variables assessed
include body temperature, study-specific definitions of fever, and neurological
outcomes such as mortality and functional decline.
The findings reveal a strong association between fever and increased
mortality, as well as adverse neurological outcomes. In particular, fever
contributes to severe complications such as delayed cerebral ischemia,
hemorrhagic transformation, and cerebral edema. These are often accompanied by
increased infarct size and early worsening of neurological conditions.
Temperature control: a key to improving neurological outcomes in intensive care
This study demonstrates that fever acts as an amplifier of secondary
injuries by exacerbating inflammation, vascular damage, and hemodynamic
imbalances, thereby negatively affecting neurological outcomes. These harmful
effects are linked to increased cerebral metabolism, inflammation, and
neuronal apoptosis. While strict temperature control emerges as a
promising strategy to mitigate these effects, further research is needed to
establish optimal protocols. Multidisciplinary care, combining intensive
monitoring and tailored temperature management, remains essential for improving
patient outcomes.
