Temperature response to severe head injury and the effect on body energy expenditure and cerebral oxygen consumption

• Published in: Archives of disease in childhood 1995-06, Vol.72 (6), p.507-515
• Main Authors: Matthews, D S, Bullock, R E, Matthews, J N, Aynsley-Green, A, Eyre, J A
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Blood flow; Blood pressure; Body temperature; Body Temperature - physiology; Brain - metabolism; Calorimetry; Cerebral blood flow; Child; Child, Preschool; Children; Climate; Craniocerebral Trauma - metabolism; Craniocerebral Trauma - physiopathology; Energy; Energy expenditure; Energy metabolism; Energy Metabolism - physiology; Epinephrine - blood; Expenditures; Female; Head injuries; Humans; Hypothermia; Hypothermia, Induced; Injuries of the nervous system and the skull. Diseases due to physical agents; Intracranial Pressure - physiology; Male; Medical sciences; Oxygen consumption; Oxygen Consumption - physiology; Paracetamol; Pediatrics; Rectum - physiopathology; Temperature measurement; Traumas. Diseases due to physical agents
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.72.6.507

This study examines the relationship between core temperature and whole body energy expenditure, cerebral oxygen consumption (CMRO2), cerebral blood flow (CBF), and intracranial pressure (ICP) in severely head injured children. A total of 107 serial measurements of temperature, energy expenditure, CMRO2, CBF, and ICP were made in 18 head injured children receiving neurointensive care. Energy expenditure was measured using indirect calorimetry, and CMRO2 and CBF using the Kety-Schmidt technique. The mean rectal temperature was 37.8 degrees C (34-39.1 degrees C) despite modification with paracetamol. Within each child there was a positive relationship between rectal temperature and energy expenditure, energy expenditure increasing by a mean of 7.4% per degree C. There was no evidence of significant relationships between rectal temperature and CMRO2, CBF, or ICP. Mild induced hypothermia in two children did not result in decreased CMRO2 or CBF measurements. The efficacy of interventions aiming to modify cerebral energy metabolism by changing core temperature cannot be readily assessed by the response of the whole body.