Metabolic benefits of surface counter warming during therapeutic temperature modulation*

Badjatia, Neeraj; Strongilis, Evangelia; Prescutti, Mary; Fernández, Luís; Fernandez, Andres; Buitrago, Manuel M.; Schmidt, J. Michael; Mayer, Stephan A.

doi:10.1097/ccm.0b013e31819fffd3

Cited by 101 publications

(62 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Possible explanations for the lack of shivering in our patient group might be the small covered area by the neck pads, the small amount of temperature decline and analgosedation in most of the patients. Furthermore, in all our patients serum magnesium levels were close to the upper limit [18], following our standard treatment protocol of aSAH [17]. Despite concerns of an accidental obstruction of the jugular venous drainage or triggering of autonomous dysfunctions via vulnerable structures like the glossopharyngeal and vagal nerves or carotid bodies, we did not observe any relevant changes concerning these issues during the study period after application of the neck pads.…”

Section: Discussionmentioning

confidence: 74%

“…Side effects were defined as skin irritation, pressure marks, wound infection, disturbances in wound healing of a new tracheostomy, or shivering. Shivering, defined as involuntary, oscillatory muscular activity, and cutaneous vasoconstriction [18] was assessed together with each taken temperature value at fixed times as mentioned above and documented as absent, mild, or severe. Changes of the analgetic or sedative medication, changes in arterial blood pressure, and heart rate were documented at least hourly following the standard treatment protocol.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Resistant Fever: New Method of Local Cerebral Cooling

et al. 2010

View full text Add to dashboard Cite

Background Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to evaluate its effectiveness as a surrogate endpoint to indicate the feasibility of neck cooling as a new method for intractable fever. Methods Nine patients with ten episodes of intractable fever and aneurysmal subarachnoid hemorrhage were treated with one of two different shapes of specifically adapted cooling neck pads. Temperature values of the brain, blood, and urinary bladder were taken close meshed after application of the cooling neck pads up to hour 8.Results The brain, blood, and urinary bladder temperatures decreased significantly from hour 0 to a minimum in hour 5 (P < 0.01). After hour 5, instead of continuous cooling in all the patients, the temperature of all the three sites remounted. Conclusion This study showed the practicability of local cooling for intractable fever using the newly developed neck pads in the daily setting of NICU patients.

show abstract

Section: Discussionmentioning

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Treatment of Resistant Fever: New Method of Local Cerebral Cooling

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Nonpharmacological interventions [12][13][14]29,30 (Table 3) such as skin warming reduce the vasoconstriction and shivering thresholds because the thresholds are negatively and linearly related to skin temperature. 9 Skin counterwarming techniques are thought to be effective because mean skin temperature represents approximately 20% of the total regulatory input.…”

Section: Nonpharmacological Methodsmentioning

confidence: 99%

“…Nonpharmacological methods have had limited use in hospitals. However, research [12][13][14][15] has shown that the use of skin counterwarming techniques is beneficial as an adjunct therapy in the management of shivering during therapeutic hypothermia.…”

Section: Management Of Shivering During Therapeutic Hypothermiamentioning

confidence: 99%

Optimal Management of Shivering During Therapeutic Hypothermia After Cardiac Arrest

Logan

Sangkachand²,

Funk

2011

Critical Care Nurse

View full text Add to dashboard Cite

Both pharmacological and nonpharmacological methods are used to control shivering in therapeutic hypothermia. An evidence-based protocol based on the most current research has been developed for the management of shivering during therapeutic hypothermia. Meperidine is the drug of choice and provides the greatest reduction in the shivering threshold. Other effective pharmacological agents recommended for reducing the threshold include dexmedetomidine, midazolam, fentanyl, and magnesium sulfate. In addition, skin counterwarming techniques, such as use of an air-circulating blanket, are effective nonpharmacological methods for reducing shivering when used in conjunction with medication. As a last resort, neuromuscular blocking agents are considered appropriate therapy for management of refractory shivering.

show abstract

“…13 Additionally, interobserver reliability is high in patients being actively cooled after stroke. 22 Thus, the BSAS has potential utility as a clinical and research tool for the evaluation of shivering in the setting of TTM.…”

mentioning

confidence: 99%