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

Oddo, Mauro; Frangos, Suzanne; Maloney-Wilensky, Eileen; Kofke, W. Andrew; Roux, Peter D. Le; Levine, Joshua M.

doi:10.1007/s12028-009-9280-2

Cited by 105 publications

(46 citation statements)

References 36 publications

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“…Shivering is also associated with a significant decrease in brain tissue oxygenation, correlating with the intensity of cooling [29]. A significant correlation has been found between the magnitude of shivering-associated decrease in brain tissue oxygenation and circulating water temperature.…”

Section: Shiveringmentioning

confidence: 90%

“…A total of 24 original research studies evaluating fever in SAH were identified: 9 studies evaluating fever and outcome (Table 1) [1-3, 5, 9, 12-15], 12 studies evaluating temperature control strategies (Table 2) [16][17][18][19][20][21][22][23][24][25][26][27], and 3 shivering (Table 3) [29,30]. Outcome data included 4 prospective studies, with the remainder cohort data or retrospective analyses.…”

Section: Summary Of the Literaturementioning

confidence: 99%

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Fever Management in SAH

2011

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An electronic literature search through August 2010 was performed to obtain articles describing fever incidence, impact, and treatment in patients with subarachnoid hemorrhage. A total of 24 original research studies evaluating fever in SAH were identified, with studies evaluating fever and outcome, temperature control strategies, and shivering. Fever during acute hospitalization for subarachnoid hemorrhage was consistently linked with worsened outcome and increased mortality. Antipyretic medications, surface cooling, and intravascular cooling may all reduce temperatures in patients with subarachnoid hemorrhage; however, benefits from cooling may be offset by negative consequences from shivering.

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Section: Shiveringmentioning

confidence: 90%

Section: Summary Of the Literaturementioning

confidence: 99%

Fever Management in SAH

2011

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“…There is a report that body cooling might cause decreased oxygen pressure in the brain tissue when shivering started [12]. Hypothermia prolongs recovery from anesthesia due to decrease in minimum alveolar concentration of inhalation anesthetics, and due to prolonged recovery of muscle relaxants [13].…”

Section: Problems and Benefits Of Hypothermiamentioning

confidence: 99%

Amino Acids during Perioperative Period

Yokoyama¹,

Yamaoka²,

Hitosugi³

et al. 2017

OJAnes

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During anesthesia, thermoregulation is impaired and hypothermia will frequently occur in most patients. Hypothermia affects immunologic activity, bleeding tendency and the recovery from anesthesia. Therefore, it may prolong hospital stay, and increase morbidity, e.g. surgical site infections, cardiac events and multiple organ dysfunctions in trauma. External warming is often used to prevent hypothermia. However, infusion of amino acids is also valuable to prevent hypothermia due to their enhanced thermogenic action under anesthesia. During surgery, amino acids administration would maintain the body homeostasis, and counteract the disadvantageous fasting metabolism. Postoperatively, amino acids may be advantageous for the healing of the surgical wound. Thus, appropriate nutritional management, including glucose, during the perioperative period would prevent catabolism, frequently occurring after surgery. Protocols like ERAS (Enhanced Recovery After Surgery) are proposed for quick recovery after surgery. ERAS protocol recommends preoperative carbohydrate and early enteral nutrition, but does not include infusion of amino acids during the perioperative period. During prolonged surgery, patients clearly need good nutritional support. In this article, we intend to describe the problems of hypothermia briefly, and explain the mechanism of amino acids in hypothermia prevention. In addition, we address some evidences of nutritional management during the perioperative period.

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

Cited by 105 publications

References 36 publications

Fever Management in SAH

Fever Management in SAH

Amino Acids during Perioperative Period

Hypothermia for Intracerebral Hemorrhage, Subarachnoid Hemorrhage & Spinal Cord Injury

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