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British Journal of Anaesthesia, 2002, Vol. 88, No. 2 188-192
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Effect of hypothermia on brain tissue oxygenation in patients with severe head injury

A. K. Gupta*,1,2, P. G. Al-Rawi3, P. J. Hutchinson3 and P. J. Kirkpatrick3

Departments of 1Anaesthesia, 2Neuro Critical Care and 3Neurosurgery, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 2QQ UK*Corresponding author

Background. There is renewed interest in the use of induced hypothermia as a method of neuroprotection both intraoperatively and in the intensive care management of severe brain injury. In this study we have investigated the effects of hypothermia on brain tissue oxygenation in patients with severe head injury.

Methods. Thirty patients with severe head injury (Glasgow coma score <8) were monitored with a multimodal sensor inserted into the brain which measures tissue PO2, PCO2, pH and temperature in addition to routine monitoring. Patients were cooled to a minimum of 33°C when clinically indicated.

Results. For all 30 patients brain and systemic temperature correlated well (r=0.96). Brain temperature was consistently higher than systemic temperature by 0.41±0.26°C (confidence limits). Brain tissue PO2 decreased with hypothermia, with a significant reduction below 35°C (P<0.05).

Conclusions. These results emphasize the advantage of measuring brain temperature directly, and suggest that decreasing brain temperature below 35°C may impair brain tissue oxygenation.

Br J Anaesth 2002; 88: 188–92


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