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Minimizing Shivering During Targeted Normothermia: Comparison Between Novel Transnasal and Surface
Shannon Arnold1, Michael Armahizer2, Luis F Torres3
1Program in Trauma, Shock Trauma Neurocritical Care, Department of Neurology, University of Maryland School of Medicine, 22 S. Greene Street, G7K19, Baltimore, MD, 21201, USA.
Neurocritical Care
|July 27, 2023
Summary
A novel transnasal temperature-modulating device (tnTMD) reduced shivering and related interventions compared to surface cooling methods in neurocritical care patients. This cooling approach offers a feasible option for managing fever in mechanically ventilated patients.
Area of Science:
- Neurocritical care
- Thermoregulation
- Medical device technology
Background:
- Shivering is a common adverse effect during normothermia in neurocritical care.
- Comparing shivering burden between transnasal and surface cooling is crucial for patient management.
Purpose of the Study:
- To compare shivering burden and interventions between a novel transnasal temperature-modulating device (tnTMD) and surface temperature-modulating devices (sTMDs).
- To evaluate the efficacy of tnTMD in achieving normothermia in mechanically ventilated febrile neurocritical care patients.
Main Methods:
- A case-control study compared 10 tnTMD patients with 30 sTMD patients.
- Core body temperature, shivering assessment (BSAS), and antishivering medication use were recorded.
- Time to normothermia and temperature burden were analyzed.
Main Results:
- No significant differences in time to normothermia or temperature burden between tnTMD and sTMD groups.
- Fewer tnTMD patients required pharmacologic shivering interventions (20% vs. 67%, p=0.01).
- tnTMD patients had significantly fewer shivering interventions per patient (0 vs. 4, p<0.001).
Conclusions:
- Transnasal cooling achieved similar normothermia times and temperature burden as surface cooling.
- The tnTMD approach resulted in significantly less shivering and fewer interventions.
- Transnasal cooling presents a feasible alternative for fever management in neurocritical care.
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