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首页> 外文期刊>Journal of neurosurgical anesthesiology >Treatment of refractory Fever in the neurosciences critical care unit using a novel, water-circulating cooling device: a single-center pilot experience.
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Treatment of refractory Fever in the neurosciences critical care unit using a novel, water-circulating cooling device: a single-center pilot experience.

机译：使用新型水循环冷却装置治疗神经科关键护理单元的难治性发热：单中心试验体验。

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SUMMARY: Fever after acute brain injury affects neuronal function and recovery. Standard therapies have proven to be inadequate in treating hyperthermia in this patient population. We report on safety/efficacy pilot data collected using a noninvasive, novel, water-circulating cooling device in febrile acute brain injury patients. We enrolled patients who developed fever (rectal temperature >/=38.0 degrees C) refractory to pharmacological therapy. The treatment device uses an ice water circulating system embedded in hydrogel-coated, energy transfer pads. Its thermoregulatory feedback control uses cold water (4.0 degrees C-42.0 degrees C) and was set at 36.5 degrees C for this study. We analyzed the temperature response during 600 consecutive minutes of treatment. Six consecutive patients were enrolled and seven episodes of fever were recorded; the mean age of the patients was 59.7 years (range 46-71 years; five male, one female). Diagnoses were as follows: subarachnoid hemorrhage (two), severe traumaticbrain injury (two), status epilepticus following massive cerebral infarction (one), and intracerebral/intraventricular hemorrhage (one). Hand warming was applied at treatment onset on all patients; shivering only responsive to meperidine occurred in five of them. Fever of 38.4 degrees C (range 38.0 degrees C-38.9 degrees C) was reduced to 36.9 degrees C (range 36.0 degrees C-38.0 degrees C) after 120 minutes (P < 0.001). Core temperature remained "locked" during the remainder of the treatment (36.6 degrees C, P = 0.5; 36.6 degrees C, P = 0.9; and 36.5 degrees C, P = 0.9 at 180, 300, and 600 minutes, respectively). Skin integrity under the pads was preserved in all study subjects. Our results indicate that use of this novel technique is safe, rapidly effective, and able to maintain sustained normothermia following fever in a cohort of critically ill neurologic/neurosurgical patients.
机译：发明内容：急性脑损伤后发烧影响神经元功能和恢复。在这种患者人群中治疗热疗的情况下，已被证明是不充分的疗法。我们报告使用非侵袭性，新型水循环冷却装置在发热急性脑损伤患者中收集的安全/效力试验数据。我们注册了发烧的患者（直肠温度> / = 38.0摄氏度）对药理学治疗的难治度。处理装置使用嵌入水凝胶涂覆的能量转移垫中的冰水循环系统。其热调节反馈控制使用冷水（4.0摄氏度C-42.0℃），并在36.5摄氏度下设定该研究。我们在连续的600分钟治疗过程中分析了温度响应。六名连续患者注册，记录了七集发烧;患者的平均年龄为59.7岁（范围46-71岁;五名男性，一名女性）。诊断如下：蛛网膜下腔出血（两），严重的创伤损伤（两），巨大脑梗死后的状态癫痫患者（一），脑/脑室内出血（一）。在所有患者的治疗发作时应用手动变暖;颤抖只对哌替啶的敏感发生在其中五分之一。在120分钟后将38.4摄氏度（范围38.0℃C-38.9℃）降低至36.9℃（范围36.0℃-38.0℃）（p <0.001）。核心温度在治疗的剩余时间内保持“锁定”（36.6℃，P = 0.5; 36.6℃，P = 0.9; 36.5℃，P = 0.9分别为180,300和600分钟）。在所有研究科目中保留了垫下方的皮肤完整性。我们的结果表明，这种新技术的使用是安全，迅速有效的，并且能够在批判性神经系统/神经外科患者的队列中保持持续的常温。

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