| Treatment of refractory fever in the neurosciences critical care unit using a novel, water-circulating cooling device. A single-center pilot experience. | |
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MedLine Citation:
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PMID: 14508172 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fever after acute brain injury affects neuronal function and recovery. Standard therapies have proven to be inadequate in treating hyperthermia in this patient population. We report on safety/efficacy pilot data collected using a noninvasive, novel, water-circulating cooling device in febrile acute brain injury patients. We enrolled patients who developed fever (rectal temperature > or =38.0 degrees C) refractory to pharmacological therapy. The treatment device uses an ice water circulating system embedded in hydrogel-coated, energy transfer pads. Its thermoregulatory feedback control uses cold water (4.0 degrees C-42.0 degrees C) and was set at 36.5 degrees C for this study. We analyzed the temperature response during 600 consecutive minutes of treatment. Six consecutive patients were enrolled and seven episodes of fever were recorded; the mean age of the patients was 59.7 years (range 46-71 years; five male, one female). Diagnoses were as follows: subarachnoid hemorrhage (two), severe traumatic brain injury (two), status epilepticus following massive cerebral infarction (one), and intracerebral/intraventricular hemorrhage (one). Hand warming was applied at treatment onset on all patients; shivering only responsive to meperidine occurred in five of them. Fever of 38.4 degrees C (range 38.0 degrees C-38.9 degrees C) was reduced to 36.9 degrees C (range 36.0 degrees C-38.0 degrees C) after 120 minutes (P<0.001). Core temperature remained "locked" during the remainder of the treatment (36.6 degrees C, P=0.5; 36.6 degrees C, P=0.9; and 36.5 degrees C, P=0.9 at 180, 300, and 600 minutes, respectively). Skin integrity under the pads was preserved in all study subjects. Our results indicate that use of this novel technique is safe, rapidly effective, and able to maintain sustained normothermia following fever in a cohort of critically ill neurologic/neurosurgical patients. |
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Authors:
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J Ricardo Carhuapoma; Kapil Gupta; William M Coplin; Salman M Muddassir; Muhammad M Meratee |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of neurosurgical anesthesiology Volume: 15 ISSN: 0898-4921 ISO Abbreviation: J Neurosurg Anesthesiol Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-09-25 Completed Date: 2004-02-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8910749 Medline TA: J Neurosurg Anesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 313-8 Citation Subset: IM |
Affiliation:
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Neurosciences Critical Care Program, Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. jcarhuap@med.wayne.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Brain Injuries / complications, physiopathology* Cryotherapy / adverse effects, instrumentation*, methods* Female Fever / complications, therapy* Humans Intensive Care Units* Male Middle Aged Pilot Projects Time Factors Water |
| Chemical | |
Reg. No./Substance:
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7732-18-5/Water |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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