ИСТИНА

Introduction Hyperthermia is a common detrimental condition in patients with acute cerebral pathology, which can worsen prognosis and outcome. The aim of this study was to evaluate the effects of hyperthermia on the intracranial pressure (ICP), cerebral perfusion pressure (CPP), arterial blood pressure (ABP), cerebral autoregulation (Prx). Materials and methods Eight patients with acute brain injury were studied. Cerebral autoregulation was assessed by the coefficient PRx (Cambridge, UK). ICP, CPP, PRx were compared before and during the time of hyperthermia development. 33 episodes of cerebral hyperthermia above 38.30C were analyzed. Results Analysis of 33 episodes of hyperthermia showed an increase in cerebral temperature from 37.8 [37.6; 38] to 38.9 [38.3; 39.6]0C (P<0.01) and with the temperature difference (Delta T) of 1.2 [0.5; 2.6]0С. During hyperthermia, in the group of patients with initially normal ICP (n=25), an increase in ICP was recorded in 13 (52%) cases with median ICP of 24 [22; 28] mm Hg, while 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 with ICP > 20 mmHg increased by 41%, and with impaired autoregulation – by 38% (P>0.05). Conclusion Cerebral hyperthermia was associated with the development of intracranial hypertension in 52% of patients with initially normal ICP, while in patients with initially elevated ICP, further progression of intracranial hypertension occurred in 100% of cases. This cerebral hyperthermia-associated ICP increase was not dependent on the cerebral autoregulation.