Antipyretic treatment of noninfectious fever in children with severe traumatic brain injury |
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| Authors: | Jonathon M. Brown,Yuthana Udomphorn,Pilar Suz,Monica S. Vavilala |
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| Affiliation: | (1) Department of Biomedical Sciences, Medical Sciences Programs, Drexel University College of Medicine, 3141 Chesnut, Street, Philadelphia, PA 19104, USA;(2) Department of Anesthesiology, University of Washington School of Medicine, 1959 NE Pacific, Seattle, WA 98195, USA;(3) Department of Pediatrics, University of Washington School of Medicine, 1959 NE Pacific, Seattle, WA 98195, USA;(4) Department of Neurological Surgery, University of Washington School of Medicine, 1959 NE Pacific, Seattle, WA 98195, USA;(5) Department of Anesthesiology, University of Texas Medical School, 7000 Fannin Street, Houston, TX 77030, USA;(6) Department of Anesthesiology, Harborview Medical Center, 325 Ninth Avenue, Box 359724, Seattle, WA 98104, USA |
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| Abstract: | Objective The purpose of this study was to describe the treatment of noninfectious fever in children with severe traumatic brain injury (TBI). Materials and methods We conducted a retrospective study to compare type of and response to antipyretic treatment strategies in children less than or equal to 17 years and Glasgow Coma Scale (GCS) score less than 9. Results The average admission GCS score was 4. Forty children (35 boys, 5 girls), age 7.8 ± 5.2 years, had noninfectious fever. Seventy percent (28 of 40) received acetaminophen only, and 30% (12 of 40) received acetaminophen plus either ibuprofen or physical cooling. Time to next febrile episode was longer in patients receiving combination therapy than those receiving monotherapy (p = 0.03). Fever refractory to treatment dose or strategy occurred in more than 40% of the patients. Conclusions Early combination antipyretic therapy may be needed to effectively maintain normothermia in children with severe TBI. |
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| Keywords: | Pediatric traumatic brain injury Head trauma Fever Pyrexia Antipyretic treatment |
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