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Table 3 Studies included in the review

From: Clinical review: Brain-body temperature differences in adults with severe traumatic brain injury

Reference Study design, setting, country Population and sample size Age range (years) and GCS score Brain device and method Core device and method Calibration Deliberate thermoregulatory interventions Results (°C)
Henker et al. (1998) [16] Descriptive comparison ICU USA Severe head injury n = 8 Age: 18-58 GCS: 4-7 Site: right lateral ventricle Device: type T thermocouple (model no. 12983 Ventricular Catheter with Thermocouple; Radionics, Burlington, MA, USA) Site 1: rectum Device: Hewlett-Packard Model 21090A probe (Hewlett-Packard Company, Androver, MA, USA) Site 2: bladder Device: bladder catheter (Bardex Lubricath, model 909116; CR Bard, Inc., Convington, GA, USA) Yes Random assignment to groups Hypothermia ('target' 32°C for 48 h, n = 5) Normothermia group (n = 3) • Mean (SD) of Tbr - Tr: 0.8 (0.8) °C
• Mean (SD) of Tbr - Tbl: 1.0 (0.7) °C
Brain temperature is higher than rectal and higher than bladder temperature
Not possible to determine which patients reached the hypothermia 'target'
Rumana et al. (1998) [18] Descriptive study ICU USA Severe head injury n = 30 Mean (SD) age: 30.7 (13.0) GCS: ≤8 (n = 25); >8 (n = 5) Site: intraparenchyma Device: Licox, Kiel-Mielkendorf, Germany Site: rectum Device: 10-Fr thermistor probe (400 series, Sheridan Catheter Corporation, Argyle, NY, USA) Yes No • Mean (SD) of Tbr- Tr: 1.1 (0.6) °C
Brain temperature is higher than rectal temperature
Zhang et al. (2002) [21] Descriptive study Unclear China Severe head injury n = 18 Age: 20-73 GCS: ≤8 Site: frontal white matter Device: flexible Clark-type microcatheter (Licox-II system, GSM Co. Ltd, Germany) Site: rectum Device: not reported Unclear Mild hypothermia on all patients • Mean of Tbr - Tr at 0 hours after cooling: 0.8°C
• Mean of Tbr - Tr at 24 hours after cooling: 1.1°C
• Mean of Tbr - Tr at 72 hours after cooling: 1.4°C
Brain temperature is consistently higher at 0, 24 and 72 hours after cooling
Soukup et al. (2002) [12] Descriptive study ICU USA Severe head injury n = 58 Age: ≥ 16 GCS: ≤8 Site: parenchyma Device: Paratrend 7, Diametrics Medical Inc., Roseville, MN, USA Site: rectum Device: Hewlett Packard Unclear Mild hypothermia (n = 33);
Control (n = 25)
• Mean (SD) of Tbr -Tr in the normothermic group: 0.0 (0.5)°C
• Mean (SD) of Tbr-Tr in the hyperthermic group: 0.3 (0.5)°C
• Mean (SD) of Tbr-Tr in the therapeutic 'cooled' group: -0.2 (0.6)°C
• Mean (SD) of Tbr-Tr of spontaneous hypothermia group: -0.8 (1.4)C
         Brain temperature is higher than rectal temperature at normothermia and hyperthermia conditions, but lower during therapeutic cooling and spontaneous hypothermia
Tokutomi et al. (2003) [13] Descriptive study ICU Japan Severe brain injury n = 31 Age: 15-69 GCS: 3-5 Site: subdural Device: Camino Direct Pressure monitor (Camino Laboratories, San Diego, CA, USA) Site: rectum Device: Bi-Temp (RSP, Boston, MA, USA) Site 2: Jugular vein Device: fibreoptic catheter (manufacturer type not stated) Unclear Hypothermia therapy on all patients • Mean (SD) of Tbr- Tr: 0.5 (0.3) °C
• Mean (SD) of Tbr- Tjv: 0.3(0.3) °C
Brain temperature is higher than both rectal and jugular vein temperature
Childs et al. (2005) [19] Descriptive study ICU UK Severe TBI n = 19 Age: 19-70 GCS: 3-13 Site: brain parenchyma Device: Camino 110-4BBT, 4 Fr, fibre-optic, transducer tipped sensor (Integra Neurosciences, Andover, UK) Site: rectum Device: Mon-a- therm 400 series, 9 Fr, thermistor (Mallinckrodt Medical, Tyco Healthcare, Gosport, UK) Yes No • Mean (SD) of Tbr- Tr: -0.04 (0.9) °C
No evidence of systematic difference between brain and core temperature. Brain temperature is lower than rectal temperature
Kirk et al. (2009) [14] Descriptive study ICU UK Severe TBI n = 20 Age: 17-76 GCS: ≤8 Site: intraparenchyma Device: Neurovent-PTemp™, Raumedic AG, Münchberg, Germany Site 1: tympanic membrane Device: Core-Check thermometer (model 2090 IVAC Corporation, San Diego, California, USA)
Site 2: temporal artery, Device: model TAT5000, Exergen, Watertown, MA, USA
Unclear No • Mean (SD) of Tbr - Ttm: 0.9 (0.7) °C
• Mean (SD) of Tbr - Tta: 0.3 (0.4) °C
Brain temperature is higher than both tympanic membrane and temporal artery temperature
Temporal artery temperature is closer to brain than tympanic membrane temperature is
Puccio et al. (2009) [17] Descriptive study Neurotrauma ICU USA Severe TBI n = 42 Mean (SD) Age: 36.4 (14.8)
GCS: 3-8
Site: intraventricular Device: Licox® (Integra LifeSciences Corp., Plainsboro, NJ, USA) Site: rectum Device: not reported Unclear Induced normothermia (n = 21)
Control (n = 21)
• Mean of Tbr - Tr in the control group: -0.4°C
• Mean of Tbr - Tr in the induced normothermic group: -0.1°C
Brain temperature is lower than rectal temperature in both groups of patients
Kuo et al. (2011) [15] Descriptive study ICU Taiwan TBI n = 28 Age: 16-80 GCS: 6 (median) Site: intraparenchyma Device: 110-4BT, Pressure-Temperature Monitoring Kit (Integra Camino, San Diego, CA, USA) Site 1: rectum Device: Medi-Therm II Hyper-Hypothermia Machine (Gaymar Industries, Orchard Park, NY, USA) Site 2: temporal artery Device: Temporal Scanner™ TAT-5000 (EXERGEN, Boston, MA, USA) Yes No • Mean (SD) of Tbr - Tr: 0.23 (0.45) °C
• Mean (SD) of Tbr - Tta: 0.64 (0.60) °C
Brain temperature is higher than both rectal temperature and temporal artery temperature
Suehiro et al. (2011) [20] Descriptive study Did not specify Japan Severe TBI n = 11 Age: 15-73 GCS: ≤8 Site: intraparenchyma Device: Camino Laboratories, San Diego, California, USA Site: bladder Device: thermocouple (Terumo, Tokyo, Japan) Yes Mild hypothermia on all patients • Mean (SD) of Tbr - Tbl: -0.17 (0.02) °C
Brain temperature is lower than bladder temperature
Fischer et al. (2011) [11] Descriptive study Neuro-ICU Austria Severe TBI n = 7 Age: 21-69 GCS: 3-8 Site: intraparenchyma Device: Neurovent-Temp-P (Raumedic AG, Muenchberg, Germany) Site: bladder Device: Kendall Curity, Mansfield, Massachusetts, USA Unclear Induced normothermia (36.5°) on all patients • Mean of Tbr - Tbl: 0.1°C
Brain temperature is higher than bladder temperature during induced normothermia
  1. TBI, traumatic brain injury; Tbr, brain temperature; Tr, rectal temperature; Tbl, bladder temperature; Ttm, tympanic membrane temperature; Tta, temporal artery temperature; Tjv, jugular vein temperature.