First Use of a New Device for Administration of Buspirone and Acetaminophen to Suppress Shivering During Therapeutic Hypothermia

Therapeutic Hypothermia and Temperature Management
Akilesh HonasogeErik Kulstad

Abstract

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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Citations

Dec 27, 2017·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Akash JainErik Kulstad
May 8, 2019·Therapeutic Hypothermia and Temperature Management·Mary Kay BaderNicole Kupchik
Dec 15, 2017·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Kathryn PaezBrad Macy
Nov 21, 2020·Clinical Journal of Oncology Nursing·Linda QuinlinMilli Jefferson

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Methods Mentioned

BETA
sedation
X-ray

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