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Neurocritical Care
Published in: Neurocritical Care 2/2011

01-10-2011 | Review

Fever Management in SAH

Authors: V. Scaravilli, G. Tinchero, G. Citerio, The Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage

Published in: Neurocritical Care | Issue 2/2011

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Abstract

An electronic literature search through August 2010 was performed to obtain articles describing fever incidence, impact, and treatment in patients with subarachnoid hemorrhage. A total of 24 original research studies evaluating fever in SAH were identified, with studies evaluating fever and outcome, temperature control strategies, and shivering. Fever during acute hospitalization for subarachnoid hemorrhage was consistently linked with worsened outcome and increased mortality. Antipyretic medications, surface cooling, and intravascular cooling may all reduce temperatures in patients with subarachnoid hemorrhage; however, benefits from cooling may be offset by negative consequences from shivering.
Literature
1.
Diringer MN, Reaven NL, Funk SE, Uman GC. Elevated body temperature independently contributes to increased length of stay in neurologic intensive care unit patients. Crit Care Med. 2004;32:1489–95.PubMedCrossRef
2.
Wartenberg KE, Schmidt JM, Claassen J, et al. Impact of medical complications on outcome after subarachnoid hemorrhage. Crit Care Med. 2006;34:617–23.PubMedCrossRef
3.
Oliveira-Filho J, Ezzeddine MA, Segal AZ. Fever in subarachnoid hemorrhage: relationship to vasospasm and outcome. Neurology. 2001;56:1299–304.PubMed
4.
Yoshimoto Y, Tanaka Y, Hoya K. Acute systemic inflammatory response syndrome in subarachnoid hemorrhage. Stroke. 2001;32:1989–93.PubMedCrossRef
5.
Fernandez A, Schmidt JM, Claassen J, et al. Fever after subarachnoid hemorrhage: risk factors and impact on outcome. Neurology. 2007;68:1013–9.PubMedCrossRef
6.
Commichau C, Scarmeas N, Mayer SA. Risk factors for fever in the neurologic intensive care unit. Neurology. 2003;60:837–41.PubMed
7.
Ginsberg MD, Busto R. Combating hyperthermia in acute stroke: a significant clinical concern. Stroke. 1998;29:529–34.PubMedCrossRef
8.
Rossi S, Zanier ER, Mauri I, Columbo A, Stocchetti N. Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71:448–54.PubMedCrossRef
9.
Todd MM, Hindman BJ, Clarke WR, et al. Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2009;64:897–908.PubMedCrossRef
10.
11.
Aiyagari V, Diringer MN. Fever control and its impact on outcomes: what is the evidence? J Neurol Sci. 2007;261:39–46.PubMedCrossRef
12.
Hanafy KA, Morgan Stuart R, Fernandez L, et al. Cerebral inflammatory response and predictors of admission clinical grade after aneurysmal subarachnoid hemorrhage. J Clin Neurosci. 2010;17:22–5.PubMedCrossRef
13.
Claassen J, Vu A, Kreiter KT, et al. Effect of acute physiologic derangements on outcome after subarachnoid hemorrhage. Crit Care Med. 2004;32:832–8.PubMedCrossRef
14.
Naidech AM, Bendok BR, Tamul P, et al. Medical complications drive length of stay after brain hemorrhage: a cohort study. Neurocrit Care. 2009;10:11–9.PubMedCrossRef
15.
Kirkness CJ, Burr RL, Thompson HJ, Mitchell PH. Temperature rhythm in aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2008;8:380–90.PubMedCrossRef
16.
Cormio M, Citerio G. Continuous low dose diclofenac sodium infusion to control fever in neurosurgical critical care. Neurocrit Care. 2007;6:82–9.PubMedCrossRef
17.
Cormio M, Citerio G, Spear S, Fumagalli R, Pesenti A. Control of fever by continuous, low-dose diclofenac sodium infusion in acute cerebral damage patients. Intensive Care Med. 2000;26:552–7.PubMedCrossRef
18.
Carhuapoma JR, Gupta K, Coplin WM, Muddassir SM, Meratee MM. Treatment of refractory fever in the neurosciences critical care unit using a novel, water-circulating cooling device. A single-center pilot experience. J Neurosurg Anesthesiol. 2003;15:313–8.PubMedCrossRef
19.
Price T, McGloin S, Izzard J, Gilchrist M. Cooling strategies for patients with severe cerebral insult in ICU (part 2). Nurs Crit Care. 2003;8:37–45.PubMedCrossRef
20.
Mayer SA, Kowalski RG, Presciutti M, et al. Clinical trial of a novel surface cooling system for fever control in neurocritical care patients. Crit Care Med. 2004;32:2508–15.PubMedCrossRef
21.
Badjatia N, Fernandez L, Schmidt JM, et al. Impact of induced normothermia on outcome after subarachnoid hemorrhage: a case-control study. Neurosurgery. 2010;66:696–700.PubMedCrossRef
22.
Schmutzhard E, Engelhardt K, Beer R, et al. Safety and efficacy of a novel intravascular cooling device to control body temperature in neurologic intensive care patients: a prospective pilot study. Crit Care Med. 2002;30:2481–8.PubMedCrossRef
23.
Broessner G, Beer R, Lackner P, et al. Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: bicenter prospective, randomized trial. Stroke. 2009;40:e657–65.PubMedCrossRef
24.
Badjatia N, O’Donnell J, Baker JR, et al. Achieving normothermia in patients with febrile subarachnoid hemorrhage: feasibility and safety of a novel intravascular cooling catheter. Neurocrit Care. 2004;1:145–56.PubMedCrossRef
25.
Diringer MN. Treatment of fever in the neurologic intensive care unit with a catheter-based heat exchange system. Crit Care Med. 2004;32:559–64.PubMedCrossRef
26.
Hinz J, Rosmus M, Popov A, Moerer O, Frerichs I, Quintel M. Effectiveness of an intravascular cooling method compared with a conventional cooling technique in neurologic patients. J Neurosurg Anesthesiol. 2007;19:130–5.PubMedCrossRef
27.
Hoedemaekers CW, Ezzahti M, Gerritsen A, van der Hoeven JG. Comparison of cooling methods to induce and maintain normo- and hypothermia in intensive care unit patients: a prospective intervention study. Crit Care. 2007;11:R91.PubMedCrossRef
28.
Hata JS, Shelsky CR, Hindman BJ, Smith TC, Simmons JS, Todd MM. A prospective, observational clinical trial of fever reduction to reduce systemic oxygen consumption in the setting of acute brain injury. Neurocrit Care. 2008;9:37–44.PubMedCrossRef
29.
Oddo M, Frangos S, Maloney-Wilensky E, Andrew Kofke W, Le Roux PD, Levine JM. Effect of shivering on brain tissue oxygenation during induced normothermia in patients with severe brain injury. Neurocrit Care. 2009;12:10–6.CrossRef
30.
Badjatia N, Strongilis E, Gordon E, et al. Metabolic impact of shivering during therapeutic temperature modulation: the bedside shivering assessment scale. Stroke. 2008;39:3242–7.PubMedCrossRef
31.
Albrecht RF II, Wass CT, Lanier WL. Occurrence of potentially detrimental temperature alterations in hospitalized patients at risk for brain injury. Mayo Clin Proc. 1998;73:629–35.PubMedCrossRef
32.
Kilpatrick MM, Lowry DW, Firlik AD, Yonas H, Marion DW. Hyperthermia in the neurosurgical intensive care unit. Neurosurgery. 2000;47:850–5.PubMedCrossRef
33.
Rabinstein AA, Sandhu K. Non-infectious fever in the neurological intensive care unit: incidence, causes and predictors. J Neurol Neurosurg Psychiatry. 2007;78:1278–80.PubMedCrossRef
34.
O’Grady NP, Barie PS, Bartlett JG, et al. Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American college of critical care medicine and the infectious diseases society of America. Crit Care Med. 2008;36:1330–49.PubMedCrossRef
35.
Naidech AM, Bendok BR, Bernstein RA, et al. Fever burden and functional recovery after subarachnoid hemorrhage. Neurosurgery. 2008;63:212–7.PubMedCrossRef
36.
Oddo M, Frangos S, Milby A, et al. Induced normothermia attenuates cerebral metabolic distress in patients with aneurysmal subarachnoid hemorrhage and refractory fever. Stroke. 2009;40:1913–6.PubMedCrossRef
37.
Sulter G, Elting JW, Maurits N, Luijckx GJ, De Keyser J. Acetylsalicylic acid and acetaminophen to combat elevated body temperature in acute ischemic stroke. Cerebrovasc Dis. 2004;17:118–22.PubMedCrossRef
38.
Dippel DW, van Breda EJ, van der Worp HB, et al. Effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute ischemic stroke PISA, a phase II double-blind, randomized, placebo-controlled trial [ISRCTN98608690]. BMC Cardiovasc Disord. 2003;3:2.PubMedCrossRef
39.
van Breda EJ, van der Worp B, van Gemert M, et al. The effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute stroke: protocol for a phase II double-blind randomised placebo-controlled trial [ISRCTN98608690]. BMC Cardiovasc Disord. 2002;2:7.PubMedCrossRef
40.
Kasner SE, Wein T, Piriyawat P, et al. Acetaminophen for altering body temperature in acute stroke: a randomized clinical trial. Stroke. 2002;33:130–4.PubMedCrossRef
41.
Badjatia N, Kowalski RG, Schmidt JM, et al. Predictors and clinical implications of shivering during therapeutic normothermia. Neurocrit Care. 2007;6:186–91.PubMedCrossRef
42.
Ma L, Liu WG, Zhang JM, et al. Magnesium sulphate in the management of patients with aneurysmal subarachnoid haemorrhage: a meta-analysis of prospective controlled trials. Brain Inj. 2010;24:730–5.PubMedCrossRef
43.
Wong GKC, Poon WS, Chan MTV, et al. Intravenous magnesium sulphate for aneurysmal subarachnoid hemorrhage (IMASH): a randomized, double-blinded, placebo-controlled, multicenter phase III trial. Stroke. 2010;41:921–6.PubMedCrossRef
44.
Wong GK, Boet R, Poon WS, et al. Intravenous magnesium sulphate for aneurysmal subarachnoid hemorrhage: an updated systemic review and meta-analysis. Crit Care (London, England). 2011;15:R52.CrossRef
Metadata
Title
Fever Management in SAH
Authors
V. Scaravilli
G. Tinchero
G. Citerio
The Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage
Publication date
01-10-2011
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 2/2011
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-011-9588-6

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