gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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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

Meeting Abstract

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  • corresponding author T. Hoell - Department of Neurosurgery, Bergmannstrost Hospital, Halle/Saale
  • B. Hessel - Department of Neurosurgery, Bergmannstrost Hospital, Halle/Saale
  • B. C. Kern - Department of Neurosurgery, Bergmannstrost Hospital, Halle/Saale
  • L. Mende - Department of Anesthesiology, Bergmannstrost Hospital, Halle/Saale
  • M. Nagel - Department of Neurosurgery, Bergmannstrost Hospital, Halle/Saale
  • G. Huschak - Department of Anesthesiology, Bergmannstrost Hospital, Halle/Saale

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP060

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0328.shtml

Published: May 4, 2005

© 2005 Hoell et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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.