The EMCOOLs surface cooling system for fever control in neurocritical care patients: A pilot study.
Clin Neurol Neurosurg
; 184: 105412, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-31323544
ABSTRACT
OBJECTIVES:
Fever occurs in up to 50% of critically-ill patients with acute neurological injury. Small temperature elevations have been correlated with increased morbidity and mortality in this patient population. We sought to evaluate a novel single-use surface cooling system for the treatment of fever in patients with acute brain injury. PATIENTS ANDMETHODS:
We conducted a retrospective analysis of a prospective product evaluation using the EMCOOLS Flex.Pad™ system for acute fever (≥38.3⯰C) in our 16-bed neuro-ICU. Four refrigerated pads (-18⯰C) were applied to the chest, back, and anterior thighs. Core temperature (bladder) was continuously recorded over 4â¯h, and the highest Bedside Shivering Assessment Scale (BSAS) score was recorded hourly.RESULTS:
Twelve subjects were included in the analysis. Mean age was 55⯱â¯9 years, 9 patients were men, and mean weight was 85⯱â¯12â¯kg. The most common primary diagnoses were subarachnoid (Nâ¯=â¯5) and intracerebral (Nâ¯=â¯4) hemorrhage. Application of the EMCOOLS system resulted in a linear 1.3⯱â¯0.6⯰C drop (T0avgâ¯=â¯38.9 °C, T90avgâ¯=â¯37.6 °C, Pâ¯=â¯0.0032) in mean temperature over 90â¯min, followed by a plateau with only one subject rebounding to >38⯰C within 4â¯h. Normothermia (<38.0 °C) was achieved in all but one patient (92%) in an average of 65â¯min. Comatose patients displayed a non-significantly higher degree of cooling at 90â¯min than did awake subjects (ΔTcomaâ¯=â¯1.74⯰C vs ΔTawakeâ¯=â¯0.74⯰C hr-1, Pâ¯=â¯0.067). There was no observed skin irritation upon removal of the device for any patients.CONCLUSION:
The EMCOOLs system is a well-tolerated, safe and effective short-term intervention for control of fever in neurological patients. Future studies are needed to compare efficacy of the EMCOOLs to other devices and interventions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
/
Cuidados Críticos
/
Febre
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Neurol Neurosurg
Ano de publicação:
2019
Tipo de documento:
Article