A Prospective, Observational Clinical Trial of Fever Reduction to Reduce Systemic Oxygen Consumption in the Setting of Acute Brain Injury

Hata, J. Steven; Shelsky, Constance; Hindman, Bradley J.; Smith, Thomas C.; Simmons, Jonathan; Todd, Michael M.

doi:10.1007/s12028-007-9015-1

Cited by 38 publications

(26 citation statements)

References 39 publications

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“…Induced normothermia and general patient management, however, were similar among the subjects studied and were standardized according to local protocols. Fifth, consistent with recent studies [9,33], shivering was defined as the presence of high frequency repetitive, irregular, muscle activity that involves more than one muscle group or the whole body. This seems appropriate to adequately assess the impact of shivering on brain tissue oxygenation.…”

Section: Study Limitationsmentioning

confidence: 62%

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Effect of Shivering on Brain Tissue Oxygenation During Induced Normothermia in Patients With Severe Brain Injury

et al. 2009

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In patients with severe brain injury treated with induced normothermia, shivering was associated with a significant decrease of PbtO(2), which correlated with the intensity of cooling. Monitoring of therapeutic cooling with computerized thermoregulatory systems may help prevent shivering and optimize the management of induced normothermia. The clinical significance of shivering-induced decrease in brain tissue oxygenation remains to be determined.

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Section: Study Limitationsmentioning

confidence: 62%

“…Shivering is frequently observed and may limit the effectiveness of therapeutic cooling [9]. Studies in brain-injured animals suggest that untreated shivering during induced cooling negates the neuroprotective effects of temperature control [10,11].…”

Section: Introductionmentioning

confidence: 99%

Effect of Shivering on Brain Tissue Oxygenation During Induced Normothermia in Patients With Severe Brain Injury

et al. 2009

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“…Bir çalışmada, hastaların %25'inde fiziksel soğutma yön-temlerinin beden sıcaklığını %32 oranında düşürdüğü bildirilmiştir (9). TBY'lı hastalarda asetominofen ile birlikte periferik soğutmanın uygulandığı hastalarda beden sıcak-lığının 38.6 0 C'den 36.3 0 C'ye düştüğü, sistemik oksijen tü-ketiminin ise %27 oranında azaldığı bulunmuştur (26). Bu çalışmada da, bir hasta dışında tüm hastaların ateş kontrolünde farmakolojik ajanlar ile birlikte fiziksel soğutma yöntemlerinin de uygulandığı belirlendi.…”

Section: Grafikunclassified

Nöroşirurji Yoğun Bakım Ünitesinde Ateş Kontrolünde Uygulanan Hemşirelik Girişimleri

Uğraş¹,

Yüksel²,

Yılmaz³

et al. 2020

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ÖZETGiriş-Amaç: Bedenin önemli savunma mekanizmalarından biri olan ateş, nöroşirürji hastalarında metabolik aktiviteyi hızlandıra-rak, kafa içi basınç (KİB) artışına neden olmakta ve iyileşme sürecini olumsuz etkilemektedir. Literatürde, nöroşirürji hastalarında ateş kontrolünün, ateşe bağlı gelişebilecek sorunların önlenmesinde etkili olduğu bildirilmektedir. Gereç-Yöntem NURSING INTERVENTIONS TO CONTROL FEVER IN A NEUROSURGICAL INTENSIVE CARE UNIT ABSTRACTIntroduction: Whilst fever is one of the key defence mechanisms of the body, it also causes raised intracranial pressure (ICP) by accelerating metabolic activity in neurosurgical patients and adversely affects the healing process. In the literature, fever control in neurosurgical patients is reported to be effective in preventing adverse consequences arising from uncontrolled fever.Material and Methods: This study employs a retrospective descriptive methodology. It was undertaken by examining a sample of medical records for 72 patients. All were over 18 years of age, had remained in the Neurosurgical Intensive Care Unit of a University Hospital for at least one week and had a recorded axillary temperature exceeding 38°C. Written permission from the Ethics Committee of the relevant institution was obtained to allow the research to proceed. Data were gathered between September 2013 and February 2014 using a data collection form developed by the researchers. Descriptive statistical methods (frequency, average, standard deviation) were used for the data analysis.Results: 72 out of 180 (40%) patients admitted to NICU between 2010 and 2014 developed a fever. The principal interventions by nurses to maintain fever control were identified as: giving an antipyretic agent by doctor's order (98.6%), using a cooling electrical fan (88.9%), giving a tepid bed bath (75%) and adjusting the room temperature or removing blankets (72.2%). The most frequently used antipyretic agents were identified as metamizole sodium (27.8%), a combination of metamizole sodium and paracetamol (26.4%) or paracetamol alone (16.7%). Conclusion:From the study data, it was determined that the most frequent method used to provide fever control in NICU patients was pharmacological, and that the most frequently used nursing interventions were attempts at physical cooling.

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“…Similar to any condition for which therapeutic hypothermia is employed, shivering should be avoided if possible and treated aggressively if present. Shivering has been associated with higher oxygen consumption, reduced PbtO2, higher ICP and lower CPP and higher resting energy expenditure (52)(53)(54). A substudy of the Intraoperative Hypothermia Aneurysm Surgery Trial revealed that bradycardia, a common and expected side effect of hypothermia, was associated with a higher 3-month mortality rate after SAH.…”

Section: Therapeutic Hypothermia For Subarachnoid Hemorrhagementioning

confidence: 99%

Hypothermia for Intracerebral Hemorrhage, Subarachnoid Hemorrhage & Spinal Cord Injury

Tannehill¹

2013

Therapeutic Hypothermia in Brain Injury

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A Prospective, Observational Clinical Trial of Fever Reduction to Reduce Systemic Oxygen Consumption in the Setting of Acute Brain Injury

Abstract: Fever reduction in acute brain injury appears to significantly reduce systemic VO2, but is highly dependent on shivering control.

Cited by 38 publications

References 39 publications

Effect of Shivering on Brain Tissue Oxygenation During Induced Normothermia in Patients With Severe Brain Injury

Effect of Shivering on Brain Tissue Oxygenation During Induced Normothermia in Patients With Severe Brain Injury

Nöroşirurji Yoğun Bakım Ünitesinde Ateş Kontrolünde Uygulanan Hemşirelik Girişimleri

Hypothermia for Intracerebral Hemorrhage, Subarachnoid Hemorrhage & Spinal Cord Injury

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