Artikel
Negative brain/body temperature quotient is an early indicator of brain death
Ein negativer Quotient aus Hirn- und Körpertemperatur ist ein Frühindikator für den Hirntod
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
Text
Objective
The diagnosis of brain death under intensive care conditions is still delicate due to medication, rest perfusion phenomena or ICP variations in craniectomized patients. The investigation of the relationship of brain- and body temperature revealed a temperature constellation that was highly specific for the identification of brain death.
Methods
In 35 consecutive neurosurgical patients brain temp., core temp. and ICP were recorded continuously with a 5 min interval. In 5 patients the onset of brain death was recorded. Brain temperature sensor: combined ICP/temperature probe (Raumedic®), Core temperature sensor: urinary catheter with temperature probe (Rüsch®). Combined sampling error: <0.13°C. None of the patients was treated with hypothermia. The ICP/temperature probes were implanted 3 cm deep into the frontal parenchyma. Design: prospective, non randomized, open labeled.
Results
Five (5) out of 35 patients suffered from brain death due to increased ICP. After an average time of 2 h the brain temperature fell below the body temperature. Brain temperature became constant at 2°C below body temperature. In patients with sufficient brain perfusion mean brain temperature was 0.3°C higher than the core temperature, p<0.001. Brain death was diagnosed independently of the temperature measurement according to legal rules. Barbiturate treatment did not influence the effect.
Conclusions
The observation of the temperature reversal might be explained by the loss of heat transportation due to circulation break down. A second effect is the termination of brain metabolism. Advantages of this method are an early detection of an objective parameter, simple recording, no additional technical diagnostic instruments and irrelevance of medication. We propose the negative quotient of brain- and body temperature as a relevant diagnostic criterion of brain death.