Esophageal Cooling Device Versus Other Temperature Modulation Devices for Therapeutic Normothermia in Subarachnoid and Intracranial Hemorrhage
| Autor: | Brigid Blaber, Neeraj Badjatia, Melissa Motta, Brittany Barnaba, Christopher Melinosky, Wan-Tsu Chang, Joseph Haymore, Imad R. Khan, Gunjan Parikh, Michael J Armahizer, Mary Ann Bautista |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male animal structures Subarachnoid hemorrhage Fever subarachnoid hemorrhage medicine.medical_treatment Targeted temperature management Critical Care and Intensive Care Medicine targeted temperature management 03 medical and health sciences 0302 clinical medicine Refractory Hypothermia Induced medicine Humans cardiovascular diseases Adverse effect Aged Retrospective Studies normothermia Intracerebral hemorrhage Body surface area business.industry Shivering Central Nervous System Depressants 030208 emergency & critical care medicine Retrospective cohort study Original Articles Middle Aged medicine.disease intracerebral hemorrhage Anesthesiology and Pain Medicine Anesthesia esophageal cooling device Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Therapeutic Hypothermia and Temperature Management |
| ISSN: | 2153-7933 2153-7658 |
| Popis: | Achieving and maintaining normothermia (NT) after subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) often require temperature modulating devices (TMD). Shivering is a common adverse effect of TMDs that can lead to further costs and complications. We evaluated an esophageal TMD, the EnsoETM (Attune Medical, Chicago, IL), to compare NT performance, shiver burden, and cost of shivering interventions with existing TMDs. Patients with SAH or ICH and refractory fever were treated with the EnsoETM. Patient demographics, temperature data, shiver severity, and amounts and costs of medications used for shiver management were prospectively collected. Controls who received other TMDs were matched for age, gender, and body surface area to EnsoETM recipients, and similar retrospective data were collected. All patients were mechanically ventilated. Fever burden was calculated as areas of curves of time spent above 37.5°C or 38°C. Demographics, temperature data, and costs of EnsoETM recipients were compared with recipients of other TMDs. Eight EnsoETM recipients and 24 controls between October 2015 and November 2016 were analyzed. There were no differences between the two groups in demographics or patient characteristics. No difference was found in temperature at initiation (38.7°C vs. 38.5°C, p = 0.4) and fever burden above 38°C (-0.44°C × hours vs. -0.53°C × hours, p = 0.47). EnsoETM recipients showed a nonsignificant trend in taking longer to achieve NT than other TMDs (5.4 hours vs. 2.9 hours, p = 0.07). EnsoETM recipients required fewer shiver interventions than controls (14 vs. 30, p = 0.02). EnsoETM recipients incurred fewer daily costs than controls ($124.27 vs. $232.76, p = 0.001). The EnsoETM achieved and maintained NT in SAH and ICH patients and was associated with less shivering and lower pharmaceutical costs than other TMDs. Further studies in larger populations are needed to determine the EnsoETM's efficacy in comparison to other TMDs. |
| Databáze: | OpenAIRE |
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