Control of febrile shivering during amphotericin B therapy

"Rigors" of febrile shivering often complicate therapy with amphotericin B (AmB) in immunosuppressed patients with cancer. Violent muscle contractions cause physical and emotional distress as well as dread of future therapy. This experimental study tested the effectiveness of a nursing measure in 20 hospitalized adult patients with cancer. In addition, the effects of shivering on myocardial oxygen consumption were studied. Based on Abbey's Model of Nursing Action, wraps of terry cloth toweling were applied to extremities to protect dominant skin sensors against heat loss. Patients with wrapped extremities had shorter, less severe shivering episodes than controls (p = 0.04) and required less meperidine for shivering suppression (p = 0.04). Shivering significantly elevated myocardial oxygen consumption, reflected in the rate pressure product (RPP), above pre- or post-shivering levels (p less than 0.0001). The study reflects first-year findings of a federally funded project.