What medication is preferred for lowering core body temperature in TBI patients?

Using acetaminophen is preferred for lowering core body temperature in patients with traumatic brain injury (TBI) due to its efficacy in reducing fever. Acetaminophen acts centrally to inhibit prostaglandin synthesis in the hypothalamus, effectively lowering the set point for body temperature and providing a safer option than non-steroidal anti-inflammatory drugs (NSAIDs) in this context.

NSAIDs like ibuprofen can cause gastrointestinal bleeding and may increase the risk of renal impairment, particularly in patients who are already at risk due to TBI. Aspirin also belongs to the NSAID class and carries similar risks. In addition, aspirin is typically avoided in brain injury cases due to its potential effects on platelet function and the risks of bleeding, which could exacerbate any intracranial pathology.

While cold compresses can provide temporary relief and may assist in cooling, they are not a reliable or sufficiently effective method for significantly lowering core body temperature in the clinical setting of TBI. Therefore, acetaminophen is the safest and most effective choice for managing fever in such patients.