Objective: To determine the impact of counter warming (CW) with an air circulating blanket on shivering and metabolic profile during therapeutic temperature modulation (TTM).

Design: A prospective observational study.

Setting: An 18-bed neurologic intensive care unit.

Patients: Fifty mechanically ventilated patients with brain injury undergoing TTM with automated surface and intravascular devices.

Interventions: Fifty indirect calorimetry (IDC) measurements with and without CW during TTM.

Measurements And Main Results: IDC was continuously performed for 10-15 minutes at baseline with CW (phase I), off CW (phase II), and again after the return of CW (phase III). Shivering severity during each phase was scored on a scale of 0-3 using the Bedside Shivering Assessment Scale (BSAS). Resting energy expenditure (REE), oxygen consumption, and carbon dioxide production were determined by IDC; 56% were women, with mean age 61 +/- 15 years. At the time of IDC, 72% of patients had signs of shivering (BSAS >0). All measures of basal metabolism increased after removal of the air warming blanket (from phases I and II); REE increased by 27% and oxygen consumption by 29% (both p < 0.002). A one-point increase in baseline BSAS was noted in 55% (n = 23/42) of patients from phase I to phase II. In a multivariate analysis, sedative use (p = 0.03), baseline moderate to severe shivering (p = 0.04), and lower serum magnesium levels (p = 0.01) were associated with greater increases in REE between phase I and phase II of CW. Phase III of CW was associated with a reversal in the increases in all metabolic variables.

Conclusions: Surface CW provides beneficial control of shivering and improves the metabolic profile during TTM.

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCM.0b013e31819fffd3DOI Listing

Publication Analysis

Top Keywords

phase phase
16
phase
9
counter warming
8
therapeutic temperature
8
temperature modulation
8
metabolic profile
8
phase iii
8
oxygen consumption
8
shivering
6
metabolic
4

Similar Publications

Circadian Misalignment Impacts Cardiac Autonomic Modulation in Adolescence.

Sleep

January 2025

Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA, USA.

Study Objectives: Although heart rate variability (HRV), a marker of cardiac autonomic modulation (CAM), is known to predict cardiovascular morbidity, the circadian timing of sleep (CTS) is also involved in autonomic modulation. We examined whether circadian misalignment is associated with blunted HRV in adolescents as a function of entrainment to school or on-breaks.

Methods: We evaluated 360 subjects from the Penn State Child Cohort (median 16y) who had at least 3-night at-home actigraphy (ACT), in-lab 9-h polysomnography (PSG) and 24-h Holter-monitoring heart rate variability (HRV) data.

View Article and Find Full Text PDF

Introduction: Dolutegravir (DTG) + lamivudine (3TC) demonstrated high rates of virologic suppression (VS) and low rates of virologic failure (VF), discontinuation, and drug resistance in randomized trials. Real-world evidence can support treatment effectiveness, safety, and tolerability in clinical practice and aid in treatment decisions.

Methods: A systematic literature review (SLR) was conducted to identify studies using DTG + 3TC (January 2013-March 2024).

View Article and Find Full Text PDF

Background: This study aimed to create a comprehensive Core Outcome Set (COS) for assessing the long-term outcome (≥ 5 years) after Metabolic Bariatric Surgery (MBS), through the use of the Delphi method.

Methods: The study utilized a three-phase approach. In Phase 1, a long list of items was identified through a literature review and expert input, forming the basis for an online Delphi survey.

View Article and Find Full Text PDF

Context: DNAN/DNB cocrystals, as a newly developed type of energetic material, possess superior safety and thermal stability, making them a suitable alternative to traditional melt-cast explosives. Nonetheless, an exploration of the thermal degradation dynamics of the said cocrystal composite has heretofore remained uncharted. Consequently, we engaged the ReaxFF/lg force field modality to delve into the thermal dissociation processes of the DNAN/DNB cocrystal assembly across a spectrum of temperatures, encompassing 2500, 2750, 3000, 3250, and 3500 K.

View Article and Find Full Text PDF

Design, synthesis, and in vitro antitumor evaluation of novel benzimidazole acylhydrazone derivatives.

Mol Divers

January 2025

State Key Laboratory of Green Pesticide, Key Laboratory of Green Pesticide and Agricultural Bioengineering, Ministry of Education, Center for R&D of Fine Chemicals of Guizhou University, Guiyang, Guizhou, 550025, People's Republic of China.

This study focuses on the design, synthesis, and evaluation of benzimidazole derivatives for their anti-tumor activity against A549 and PC-3 cells. Initial screening using the MTT assay identified compound 5m as the most potent inhibitor of A549 cells with an IC of 7.19 μM, which was superior to the positive agents 5-Fluorouracil and Gefitinib.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!