Evidence map›Paper›PMID 37498457›Full record

ArticleNeurocritical care2023

Minimizing Shivering During Targeted Normothermia: Comparison Between Novel Transnasal and Surface Temperature-Modulating Devices.

Shannon Arnold, Michael Armahizer, Luis F Torres, Hemant Tripathi, Harikrishna Tandri, Jason J Chang, H Alex Choi, Neeraj Badjatia

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03360656 (Transnasal Induction of Normothermia in Febrile Stroke Patients), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT03360656 nacompletednot on this map

Transnasal Induction of Normothermia in Febrile Stroke Patients

TypeinterventionalSponsorCoolTech LLCRan2018 to 2022Enrolled30ConditionsStroke, Ischemic, Stroke Hemorrhagic, Fever, SeizuresArmsTransnasal Thermal Regulating Device
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Neuroprotection provided by hypothermia initiated with high transnasal flow with ambient air in a model of pediatric cardiac arrest.American journal of physiology. Regulatory, integrative and comparative physiology · 2024
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Shannon ArnoldProgram in Trauma, Shock Trauma Neurocritical Care, Department of Neurology, University of Maryland School of Medicine, 22 S. Greene Street, G7K19, Baltimore, MD, 21201, USA.
Michael ArmahizerDepartment of Pharmacy, University of Maryland Medical Center, Baltimore, USA.
Luis F TorresDepartment of Cardiology, The Johns Hopkins Hospital, Baltimore, USA.
Hemant TripathiDepartment of Critical Care Medicine, MedStar Washington Hospital Center, Washington D.C., USA.
Harikrishna TandriDepartment of Critical Care Medicine, MedStar Washington Hospital Center, Washington D.C., USA.
Jason J ChangDepartment of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, USA.
H Alex ChoiDepartment of Cardiology, The Johns Hopkins Hospital, Baltimore, USA.
Neeraj BadjatiaProgram in Trauma, Shock Trauma Neurocritical Care, Department of Neurology, University of Maryland School of Medicine, 22 S. Greene Street, G7K19, Baltimore, MD, 21201, USA. nbadjatia@som.umaryland.edu.ORCID 0000-0003-1509-9034
University of Maryland, Baltimore · USJohns Hopkins Hospital · USMedStar Washington Hospital Center · USThe University of Texas Health Science Center at Houston · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundShivering is a common adverse effect of achieving and maintaining normothermia in neurocritical care patients. We compared the burden of shivering and shivering-related interventions between a novel transnasal temperature-modulating device (tnTMD) and surface cooling temperature-modulating devices (sTMDs) during the first 24 h of targeted normothermia in mechanically ventilated febrile neurocritical care patients.

methodsThis is a case-control study controlling for factors that impact shiver burden: age, sex, body surface area. All patients underwent transnasal cooling (CoolStat, KeyTech, Inc.) as part of an ongoing multicenter clinical trial (NCT03360656). Patients undergoing treatment with sTMDs were selected from consecutively treated patients during the same time period. Data collected included the following: core body temperature (every 2 h), bedside shivering assessment scale (BSAS) score (every 2 h), and administration of antishivering medication for a BSAS score > 1. Time to normothermia (≤ 37.5 °C), as well as temperature burden > 37.5 °C (°C × h), were compared between groups using Student's t-test for mean differences. The proportion of patients requiring interventions, as well as the number of interventions per patient, was compared using the χ

resultsThere were 10 tnTMD patients and 30 sTMD patients included in the analysis (mean age: 62 ± 4, 30% women, body surface area = 1.97 ± 0.25). There were no differences between groups in temperature at cooling initiation (tnTMD: 38.5 ± 0.2 °C vs. sTMD: 38.7 ± 0.5 °C, p = 0.3), time to ≤ 37.5 °C (tnTMD: 1.8 ± 1.5 h vs. sTMD: 2.9 ± 1.4 h, p = 0.1), or temperature burden > 37.5 (tnTMD: - 0.4 ± 1.13 °C × h vs. sTMD median [IQR]: - 0.57 ± 0.58 °C × h, p = 0.67). The number of tnTMD patients who received pharmacologic shivering interventions was lower than the number of controls (20 vs. 67%, p = 0.01). tnTMD patients also had fewer shivering interventions per patient (0 [range: 0-3] vs. 4 [range: 0-23], p < 0.001).

conclusionsA transnasal cooling approach achieved similar time to normothermia and temperature burden with less shivering than surface cooling. This approach may be a feasible option to consider for mechanically ventilated febrile neurocritical care patients.

Indexed as

Hypothermia, InducedAgedBody TemperatureCase-Control StudiesFemaleFeverHumansMaleMiddle AgedShiveringTemperatureShiveringStrokeTargeted temperature managementTransnasal cooling

Identifiers

PMID37498457
OpenAlexW4385295544

What OpenQuestion holds

Textmetadata
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Registered trials

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.