Pharmacologic options for reducing the shivering response to therapeutic hypothermia.

Abstract:

:Recent literature has demonstrated significant improvements in neurologic outcomes in patients who have received induced hypothermia in the setting of out-of-hospital cardiac arrest. Through multiple metabolic mechanisms, the induction of hypothermia slows the progression and devastation of transient cerebral hypoxia. Despite these benefits, the desired reduction in core temperature is often a challenging venture as the body attempts to maintain homeostasis through the induction of thermoregulatory processes aimed at elevating body temperature. Shivering is an involuntary muscular activity that enhances heat production in an attempt to restore homeostasis. For successful induction and maintenance of induced hypothermia, shivering, as well as other thermoregulatory responses, must be overcome. Several pharmacologic options are available, either used alone or in combination, that safely and effectively prevent or treat shivering after the induction of hypothermia. We conducted a PubMed search (1966-March 2009) to identify all human investigations published in English that discussed pharmacologic mechanisms for the control of shivering. Among these options, clonidine, dexmedetomidine, and meperidine have demonstrated the greatest and most clinically relevant impact on depression of the shivering threshold. More research in this area is needed, however, and the role of the clinical pharmacist in the development and implementation of this therapy needs to be defined.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Weant KA,Martin JE,Humphries RL,Cook AM

doi

10.1592/phco.30.8.830

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

830-41

issue

8

eissn

0277-0008

issn

1875-9114

pii

10.1592/phco.30.8.830

journal_volume

30

pub_type

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