How should fever be managed in TBI?

How should fever be managed in TBI?

• A. Aggressive fever control with antipyretics and cooling if needed
• B. Fever control is unnecessary
• C. Increase ambient temperature to elicit febrile response
• D. Fever should be treated with antibiotics only

Answer: (A)

Fever after a traumatic brain injury worsens outcomes because it raises brain metabolic demand and intracranial pressure, increasing the risk of secondary injury. The best approach is to actively control fever using antipyretics and, if needed, cooling measures to maintain normothermia. Start with medications such as acetaminophen, and escalate to cooling strategies if fever persists or is high. Shivering can counteract fever control by elevating metabolic rate, so it should be prevented or treated. If fever remains despite these measures, cooling methods like surface or intravascular cooling can help achieve and sustain target temperature. Always assess for infection, but Fever management is not achieved with antibiotics alone, since fever is not always due to infection and reducing temperature is a separate, protective goal. Deliberately increasing ambient temperature or letting fever run unchecked is not appropriate.

Fever after a traumatic brain injury worsens outcomes because it raises brain metabolic demand and intracranial pressure, increasing the risk of secondary injury. The best approach is to actively control fever using antipyretics and, if needed, cooling measures to maintain normothermia. Start with medications such as acetaminophen, and escalate to cooling strategies if fever persists or is high. Shivering can counteract fever control by elevating metabolic rate, so it should be prevented or treated. If fever remains despite these measures, cooling methods like surface or intravascular cooling can help achieve and sustain target temperature. Always assess for infection, but Fever management is not achieved with antibiotics alone, since fever is not always due to infection and reducing temperature is a separate, protective goal. Deliberately increasing ambient temperature or letting fever run unchecked is not appropriate.