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Shivering in acutely ill vulnerable populations
1University of Texas Health Science Center at San Antonio, USA. holtzclaw@uthscsa.edu
AACN Clinical Issues
|October 6, 2004
Summary
Critically ill patients often experience hazardous thermoregulatory shivering, increasing oxygen demand and cardiorespiratory effort. Understanding shivering mechanisms and implementing prevention and management strategies are crucial for patient care.
Area of Science:
- Critical Care Medicine
- Physiology
- Nursing
Background:
- Thermoregulatory shivering is a significant but often overlooked hazard in critically ill patients.
- Shivering can be triggered by various factors, including heat loss during routine care, fever, blood transfusions, and certain medications.
- This response increases metabolic rate, oxygen consumption, and cardiorespiratory workload, posing risks to vulnerable patients.
Purpose of the Study:
- To elucidate the underlying thermoregulatory mechanisms involved in shivering.
- To highlight the importance of recognizing and preventing shivering in critically ill patients.
- To provide evidence-based strategies for managing shivering during fever, aggressive cooling, and postoperative recovery.
Main Methods:
- Review of thermoregulatory mechanisms and shivering physiology.
- Analysis of clinical scenarios where shivering occurs in critically ill patients.
- Synthesis of evidence-based interventions for shivering prevention and management.
Main Results:
- Shivering is induced by temperature gradients and environmental stimuli acting on thermoregulatory pathways.
- Patients undergoing procedures, experiencing fever, or receiving transfusions are at high risk.
- Effective assessment and documentation of shivering are essential for appropriate intervention.
Conclusions:
- Nurses require knowledge of shivering's anatomical progression and physiological impact to effectively manage this response.
- Preventive measures and targeted interventions are vital to mitigate the negative consequences of shivering in critical care.
- Comprehensive assessment and documentation guide the implementation of evidence-based shivering management strategies.
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