Authors
Thomas Schmitt, Chloe LE Cossec, Marine DE Mesmay, Pierre Trouiller, Eleonore Bouchereau, Nicolas Engrand
Published in
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. Pages 271678X261496659. Oct 02, 2026. Epub Oct 02, 2026.
Abstract
BackgroundTargeted temperature management (TTM) is widely used to prevent secondary brain injury in febrile brain-injured patients, and it almost always targets systemic temperature (ST). However, because the therapeutic target is the brain, brain temperature (BT) may represent a more relevant target. We investigated whether BT-targeted TTM improved BT control compared with conventional ST-targeted TTM.MethodsBrain-TTM was a single-center, prospective, randomized controlled pathophysiology study including brain-injured patients monitored with an intracerebral pressure probe incorporating a thermal sensor. Patients with BT ≥38.5°C requiring TTM were randomized to BT-targeted or ST-targeted (bladder temperature) TTM. BT and ST were recorded every minute for 12 hours.ResultsThirty-four patients were included (17 per group). Median age was 46 years (IQR 42-53), and 68% were men. During the maintenance phase (H3-H12), the median proportion of time with BT within the target range (36.0-37.0°C) was 84% (IQR 53-99) in the BT-targeted group and 89% (IQR 63-92) in the ST-targeted group (primary outcome, p=0.89). Target attainment at H3 was similar (p=0.49). The BT-ST gradient increased from 0.11±0.07°C during induction to 0.30±0.06°C during maintenance. Per-protocol analyses were consistent.ConclusionBT-targeted TTM did not improve BT control compared with ST-targeted TTM.
PMID:
42827363
Bibliographic data and abstract were imported from PubMed on 03 Oct 2026.
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