ИСТИНА

Introduction Hyperthermia is a common pathological condition in patients with acute cerebral pathology in NICU department, which can worsen the prognosis and outcome. One of the mechanisms for the implementation of the damaging effect of hyperthermia is the progression of cerebral edema, impaired cerebral autoregulation and the elevation of intracranial hypertension. The aim of the study was to study the effect of hyperthermia on the intracranial pressure (ICP), cerebral-perfusion pressure (CPP), arterial blood pressure (ABP), cerebral autoregulation (Prx). Materials and methods 8 patients with acute brain injury, signs of cerebral edema and intracranial hypertension were studied. Cerebral autoregulation was assessed by the coefficient autoregulation (PRx) (Soft ICM + Cambridge, UK). ICP, CPP, BP, PRx were compared before and during time of hyperthermia development. 33 episodes of cerebral hyperthermia over 38.30 C were analyzed. Statistica 10.0 (StatSoft) was used for statistical processing. Results Analysis of 33 episodes of hyperthermia showed an increase cerebral temperature from 37.8 [37.6; 38] to 38.9 [38.3; 39.6] 0C and with a delta of temperature the 1.2 [0,5; 2,6] 0С. Of all the monitoring parameters, only ICP was significantly changed, which increased (p <0.01) by 6 [3; 11] mm Hg. During hyperthermia in the group of observations with initially normal ICP (n=25), an increase in ICP was recorded in 13 (52%) cases with a median ICP of 24 [22; 28] mm Hg, and in the group with initially elevated ICP (n=8), the severity of intracranial hypertension increased in all 8 (100%) cases to 31 [27; 32] mm Hg (p <0.01). In cases with intact autoregulation, the number of episodes ICP > 20 mmHg increases by 41%, and with impaired autoregulation - by 38%, without a significant difference between the groups. Conclusion During cerebral hyperthermia intracranial hypertension is developed in 52% of cases (in cases with initial normal ICP), and in the presence of elevated ICP, further progression of intracranial hypertension occurs in 100% of cases. During cerebral hyperthermia, an increase in ICP may develop both with intact and impaired cerebral autoregulation.