Trial reportNeurocritical care2007
Continuous low dose diclofenac sodium infusion to control fever in neurosurgical critical care.
Trial report in Neurocritical care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Modest cooling therapies (35ºC to 37.5ºC) for traumatic brain injury.The Cochrane database of systematic reviews · 2014Pooled it
- Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference.Neurocritical care · 2011Guideline
- Effect of extended intravenous diclofenac infusions on brain tissue oxygenation in patients with acute brain injury.Intensive care medicine experimental · 2025Article
- Pharmacologic Management of Central Fever in Patients With Acute Brain Injury.Ochsner journal · 2025Review
- Diclofenac Sodium for Fever Control in Neurocritical Care: A Systematic Review.Journal of clinical medicine · 2023Review
- Colistin co-administration with other nephrotoxins: experience of teaching hospital of Latvia.International journal of clinical pharmacy · 2021Article
- In a model of SAH-induced neurogenic fever, BAT thermogenesis is mediated by erythrocytes and blocked by agonism of adenosine A1 receptors.Scientific reports · 2021Article
- Continuous intravenous low-dose diclofenac sodium to control a central fever after ischemic stroke in the intensive care unit: a case report and review of the literature.Journal of medical case reports · 2019Review
- How I manage intracranial hypertension.Critical care (London, England) · 2019Article
- Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.Critical care (London, England) · 2018Article
- Should we treat pyrexia? And how do we do it?Critical care (London, England) · 2016Review
- Early brain injury after aneurysmal subarachnoid hemorrhage: a multimodal neuromonitoring study.Critical care (London, England) · 2015Article
- Take care when taking care of fever after aneurysmal subarachnoid hemorrhage.Critical care (London, England) · 2013Article
- Parenteral diclofenac infusion significantly decreases brain-tissue oxygen tension in patients with poor-grade aneurysmal subarachnoid hemorrhage.Critical care (London, England) · 2013Observational
- Fever management in SAH.Neurocritical care · 2011Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAim of this randomized prospective clinical trial is to compare two methods of antipyretics and evaluate their efficacy in controlling fever during the acute phase of brain damage.
methodsTwenty-two febrile comatose patients: 12 severe traumatic brain injury and 10 subarachnoid hemorrhage divided in 2 groups: Diclofenac low-dose infusion (10 patients) and extemporaneous boluses of NSAIDs (CTRL, 12 patients). The primary outcome measure was length of time with temperature>38 degrees C. Secondary outcome measures were: 1) to assess the effects of each antipyretic strategy on intracranial pressure (ICP), cerebral perfusion pressure (CPP), mean arterial pressure (MAP) and heart rate; 2) to monitor adverse effects of each antipyretic strategy. The baseline characteristics in the two treatment groups were similar.
resultsPrimary findings: percentage of time per patient with temperature>38 degrees C was significantly lower (P<0.0001) in the DCF group, 4% (0-22%), vs. 34% (8-56%) in CTRL group. In addition, mean T degrees , max T degrees were lower in DCF than in CTRL (P<0.05). Secondary findings: CPP and MAP were significantly higher in DCF group (P<0.05) while ICP was not different (NS). However, if ICP pre randomization was <25 mmHg, CTRL suffered a worst ICP (24+/-11 vs. 16+/-7 P=0.01), MAP (89+/-10 vs. 104+/-10 P=0.01) and CPP (75+/-10 vs. 94+/-17 P=0.01) compared to DCF. No differences between the two treatment were recorded when ICP>or=25 mmHg before randomization. There was no gastrointestinal or intracranial bleeding.
conclusionsLow dose DCF infusion is a potential useful strategy for a successful control temperature better than intermittent NSAIDs dosing, minimizing potentially brain-damaging effects of fever.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.