TY - JOUR
T1 - Temperature management in patients with acute neurological lesions
T2 - An Australian and New Zealand point prevalence study
AU - Saxena, Manoj K.
AU - Taylor, Colman B.
AU - Hammond, Naomi E.
AU - Young, Paul J.
AU - Seppelt, Ian M.
AU - Glass, Parisa
AU - Myburgh, John A.
PY - 2013
Y1 - 2013
N2 - Background: Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. Objective: To describe temperature management in patients with acute neurological lesions. Design: Prospective, observational, multicentre, single-day point-prevalence study. Participants, setting and methods: Observational data of usual practice were recorded for all patients with an intensive care admission diagnosis of acute neurological lesions and who were present in 33 intensive care units at 10:00 on the study day. Data were collected prospectively for the ensuing 24-hour period. Main outcome measures: Achieved temperature, interventions used to modify temperature and target temperature. Results: There were 106 patients with acute neurological lesions (61% with either stroke or traumatic brain injury) with a mean APACHE (Acute Physiology and Chronic Health Evaluation) II score of 19.3 ± 7.4, age of 53.5 ± 19.0 years and median time from intensive care admission to data capture of 3 days (interquartile range, 1-9). A target temperature was specified in 24% of patients. Although paracetamol was commonly used (56%), it was infrequently used at the maximum licensed dose and there was no use recorded of non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors. Physical cooling was used in 25% of patients and core temperature was measured in 32%. Measured temperature often exceeded 37.0°C (62% of readings), 37.5°C (43%) and 38.0°C (22%). Conclusions: Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
AB - Background: Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. Objective: To describe temperature management in patients with acute neurological lesions. Design: Prospective, observational, multicentre, single-day point-prevalence study. Participants, setting and methods: Observational data of usual practice were recorded for all patients with an intensive care admission diagnosis of acute neurological lesions and who were present in 33 intensive care units at 10:00 on the study day. Data were collected prospectively for the ensuing 24-hour period. Main outcome measures: Achieved temperature, interventions used to modify temperature and target temperature. Results: There were 106 patients with acute neurological lesions (61% with either stroke or traumatic brain injury) with a mean APACHE (Acute Physiology and Chronic Health Evaluation) II score of 19.3 ± 7.4, age of 53.5 ± 19.0 years and median time from intensive care admission to data capture of 3 days (interquartile range, 1-9). A target temperature was specified in 24% of patients. Although paracetamol was commonly used (56%), it was infrequently used at the maximum licensed dose and there was no use recorded of non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors. Physical cooling was used in 25% of patients and core temperature was measured in 32%. Measured temperature often exceeded 37.0°C (62% of readings), 37.5°C (43%) and 38.0°C (22%). Conclusions: Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
UR - http://www.scopus.com/inward/record.url?scp=84884582323&partnerID=8YFLogxK
M3 - Article
C2 - 23931042
AN - SCOPUS:84884582323
SN - 1441-2772
VL - 15
SP - 110
EP - 118
JO - Critical Care and Resuscitation
JF - Critical Care and Resuscitation
IS - 2
ER -