TY - JOUR
T1 - First Use of a New Device for Administration of Buspirone and Acetaminophen to Suppress Shivering during Therapeutic Hypothermia
AU - Honasoge, Akilesh
AU - Parker, Braden
AU - Wesselhoff, Kelly
AU - Lyons, Neal
AU - Kulstad, Erik
N1 - Publisher Copyright:
© Akilesh Honasoge et al. 2016; Published by Mary Ann Liebert, Inc. 2016.
PY - 2016
Y1 - 2016
N2 - Therapeutic hypothermia or targeted temperature management has been used after cardiac arrest to improve neurological outcomes and mortality. However, a side effect of temperature modulation is a centrally mediated shivering response. The Columbia Anti-Shivering Protocol sets up a systematic method of intravenous (IV) and oral medication escalation to suppress this response and preserve the benefits of this therapy. We present the case of a 59-year-old male who began shivering after therapeutic hypothermia for cardiac arrest, leading to a persistent rise in core temperature despite adequate sedation. He was also found to have gastric contents similar to coffee grounds through nasogastric tube suction. The shivering was effectively suppressed and the rising core temperature plateaued using rectal acetaminophen and buspirone administered by means of a novel device, the Macy Catheter. Also, when used in conjunction with other protocol-driven medications, the patient was able to achieve a core temperature of 33°C. The Macy Catheter appears to be a useful approach to rectally administer buspirone and acetaminophen, using an easy-to-place, nonsterile atraumatic device that requires no radiographic confirmation of placement.
AB - Therapeutic hypothermia or targeted temperature management has been used after cardiac arrest to improve neurological outcomes and mortality. However, a side effect of temperature modulation is a centrally mediated shivering response. The Columbia Anti-Shivering Protocol sets up a systematic method of intravenous (IV) and oral medication escalation to suppress this response and preserve the benefits of this therapy. We present the case of a 59-year-old male who began shivering after therapeutic hypothermia for cardiac arrest, leading to a persistent rise in core temperature despite adequate sedation. He was also found to have gastric contents similar to coffee grounds through nasogastric tube suction. The shivering was effectively suppressed and the rising core temperature plateaued using rectal acetaminophen and buspirone administered by means of a novel device, the Macy Catheter. Also, when used in conjunction with other protocol-driven medications, the patient was able to achieve a core temperature of 33°C. The Macy Catheter appears to be a useful approach to rectally administer buspirone and acetaminophen, using an easy-to-place, nonsterile atraumatic device that requires no radiographic confirmation of placement.
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U2 - 10.1089/ther.2015.0022
DO - 10.1089/ther.2015.0022
M3 - Article
C2 - 26807775
AN - SCOPUS:85006198853
SN - 2153-7658
VL - 6
SP - 48
EP - 51
JO - Therapeutic Hypothermia and Temperature Management
JF - Therapeutic Hypothermia and Temperature Management
IS - 1
ER -