Treatment of resistant fever: new method of local cerebral cooling.
BACKGROUND
Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to evaluate its effectiveness as a surrogate endpoint to indicate the feasibility of neck cooling as a new method for intractable fever.


METHODS
Nine patients with ten episodes of intractable fever and aneurysmal subarachnoid hemorrhage were treated with one of two different shapes of specifically adapted cooling neck pads. Temperature values of the brain, blood, and urinary bladder were taken close meshed after application of the cooling neck pads up to hour 8.


RESULTS
The brain, blood, and urinary bladder temperatures decreased significantly from hour 0 to a minimum in hour 5 (P < 0.01). After hour 5, instead of continuous cooling in all the patients, the temperature of all the three sites remounted.


CONCLUSIONS
This study showed the practicability of local cooling for intractable fever using the newly developed neck pads in the daily setting of NICU patients.
Mink
Susanne
S
Department of Neurosurgery, Neuroscience Intensive Care Unit, University Hospital of Zurich, Zurich, Switzerland. smink@partners.org
Schwarz
Urs
U
Mudra
Regina
R
Gugl
Christoph
C
Fröhlich
Jürg
J
Keller
Emanuela
E
D000328:Adult; D003422:Critical Care; D004867:Equipment Design; D005260:Female; D005334:Fever / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome