(1011) Evaluation of Bromocriptine for Reduction of Fever in Patients With Acute Neurologic Injury

Introduction: Fever is prevalent among patients in the neurologic intensive care unit (Neuro ICU) and can be associated with higher risk of mortality and longer ICU and hospital lengths of stay. Dopamine (D2) receptor agonists, such as bromocriptine, have been shown to decrease body temperature by reduction of sympathetic outflow but have not been widely studied in patients with neurologic injury.

Methods: This was a retrospective, cohort study conducted at a Level I Trauma Center and Comprehensive Stroke Center. We identified patients who received bromocriptine 5 mg every 8 hours and acetaminophen (BROMO) or acetaminophen monotherapy (APAP) from August 1, 2023 to February 29, 2024. The primary outcome of this study was fever reduction (°C) at 72 hours following initiation of therapy.

Results: A total of 67 patients met inclusion criteria; 28 patients were included in the BROMO group and 39 patients in the APAP group. The average initial maximum temperature was 38.9°C in the BROMO group versus 38.6°C in the APAP group (p=0.001). There was a significant reduction in temperature at 72 hours in the BROMO group compared to the APAP group (-0.86°C vs -0.39°C, p=0.017). This difference was also noted at 24 hours (-0.7°C vs -0.06°C, p=0.001) and 48 hours (-0.8°C vs -0.39°C, p=0.004). There were no safety events noted with either therapy.

Conclusions: This study found that bromocriptine is safe and effective when used in combination with acetaminophen for fever management among patients with acute neurologic injury. Bromocriptine provides an alternative to more intensive cooling measures that may increase ICU and hospital lengths of stay. Additional studies are needed to further elucidate the role of bromocriptine in the management of fever among Neuro ICU patients.