Progress in shivering control

Mahmood, M. Asim; Zweifler, Richard M.

doi:10.1016/j.jns.2007.04.038

Cited by 64 publications

(45 citation statements)

References 111 publications

(111 reference statements)

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“…27 Dexmedetomidine is a drug not commonly used during therapeutic Meperidine is unique among opioids in that it decreases shivering and vasoconstriction thresholds through its k-receptor activity. 8 Disadvantages of meperidine use include risk of respiratory suppression, nausea and vomiting, and seizure potential with prolonged drug administration. 8 Recently, in a study 22 of combinations of drugs, meperidine and dexmedetomidine additively reduced the shivering threshold.…”

Section: Pharmacological Methodsmentioning

confidence: 99%

“…Temperatures less than this threshold trigger vasoconstriction and shivering. 8 Thermoregulation involves integration of (1) peripheral and central thermoreceptor signals by the hypothalamus control center and (2) the efferent response via the autonomic and behavioral systems. 8 Skin, mucous membrane, and visceral receptors provide thermal input; the mean skin temperature accounts for approximately 20% of the total thermoregulatory input.…”

Section: Shiveringmentioning

confidence: 99%

“…8 Thermoregulation involves integration of (1) peripheral and central thermoreceptor signals by the hypothalamus control center and (2) the efferent response via the autonomic and behavioral systems. 8 Skin, mucous membrane, and visceral receptors provide thermal input; the mean skin temperature accounts for approximately 20% of the total thermoregulatory input. 9 The spinal cord and brain stem modulate the thermal inputs and integrate afferent information within the hypothalamus.…”

Section: Shiveringmentioning

confidence: 99%

“…9 The spinal cord and brain stem modulate the thermal inputs and integrate afferent information within the hypothalamus. 8 Differences between the set-point temperature and thermoreceptor feedback lead to vasoconstriction, piloerection, and shivering in response to cold. This shivering increases heat production 2-to 5-fold.…”

Section: Shiveringmentioning

confidence: 99%

“…This shivering increases heat production 2-to 5-fold. 8 For successful induction and maintenance of therapeutic hypothermia, the thermoregulatory responses of vasoconstriction and shivering must be controlled.…”

Section: Shiveringmentioning

confidence: 99%

See 4 more Smart Citations

Optimal Management of Shivering During Therapeutic Hypothermia After Cardiac Arrest

Logan

Sangkachand²,

Funk

2011

Critical Care Nurse

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Both pharmacological and nonpharmacological methods are used to control shivering in therapeutic hypothermia. An evidence-based protocol based on the most current research has been developed for the management of shivering during therapeutic hypothermia. Meperidine is the drug of choice and provides the greatest reduction in the shivering threshold. Other effective pharmacological agents recommended for reducing the threshold include dexmedetomidine, midazolam, fentanyl, and magnesium sulfate. In addition, skin counterwarming techniques, such as use of an air-circulating blanket, are effective nonpharmacological methods for reducing shivering when used in conjunction with medication. As a last resort, neuromuscular blocking agents are considered appropriate therapy for management of refractory shivering.

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