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Decreased Body Temperature01:29

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A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by...
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The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Targeted Temperature Management After Pediatric Cardiac Arrest: A Quality Improvement Program With Multidisciplinary

Mason P McMullin1,2, Noelle B Cadotte3, Erin M Fuchs4

  • 1Department of Pediatrics, Uniformed Services University, Bethesda, MD.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|November 25, 2024
PubMed
Summary

Implementing a targeted temperature management (TTM) bundle significantly reduced fever duration in pediatric cardiac arrest survivors. This quality improvement initiative improved patient outcomes by minimizing fever time post-cardiac arrest.

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Area of Science:

  • Pediatric Critical Care Medicine
  • Quality Improvement Science
  • Cardiovascular Research

Background:

  • Fever post-cardiac arrest is associated with worse neurological outcomes in pediatric patients.
  • Effective fever management is crucial for improving survival and recovery after cardiac arrest.
  • Current targeted temperature management (TTM) protocols require optimization for pediatric populations.

Purpose of the Study:

  • To implement a comprehensive TTM bundle in a pediatric intensive care unit (PICU).
  • To reduce the percentage of time patients experienced fever (temperature > 38°C) after cardiac arrest.
  • To achieve a target reduction in febrile time from 7% to 3.5%.

Main Methods:

  • A prospective quality improvement initiative was conducted over 16 months (April 2021 to June 2022).
  • A TTM bundle including standardized temperature goals, cooling blanket protocols, scheduled antipyretics, and shivering management was implemented.
  • Data from 29 pre-intervention historical control patients were compared with 46 intervention period patients.

Main Results:

  • The median percentage of febrile time per patient decreased from 7% (IQR, 0-13%) to 0% (IQR, 0-3%) (p < 0.001).
  • Fewer patients experienced fever at any time during the intervention period (16/46 vs. 21/29; 37% reduction; p = 0.002).
  • No significant association was found between the intervention and the development of hypothermia (< 35°C).

Conclusions:

  • Implementation of a TTM bundle effectively reduces fever duration and frequency in pediatric cardiac arrest survivors.
  • This quality improvement project demonstrates the successful application of a TTM bundle in a PICU setting.
  • The TTM bundle is a valuable strategy for improving post-cardiac arrest care in pediatric patients.