TY - JOUR
T1 - Cooling Blankets in Hospitalized Patients
T2 - Time to Reevaluate
AU - Chen, Thomas
AU - Malhotra, Prashant
AU - Khameraj, Aradhana
AU - Ong-Bello, Nelda
AU - Vyas, Pooja P.
AU - Rasul, Rehana
AU - Schwartz, Rebecca M.
AU - Farber, Bruce F.
N1 - Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Background: The therapeutic benefits and rationale for treating fevers with external cooling methods remain unclear. We aimed to describe the clinical settings in which cooling blankets (CBs) are used. Design: We conducted a retrospective chart review of CB use in adult patients admitted to our tertiary care center over a one-year period. We measured how they are used and correlations between clinical variables and their duration of use. Results: 561 patients were included in our study. The mean highest temperature during hospitalization was 39.35 °C (SD, 0.67). Shivering occurred in 176 patients (31.4%) while on a CB although 303 patients (54%) had no data regarding shivering. Discontinuation of CBs was recorded in only 177 (30.5%) cases. Among these, the median duration of use was 33.37 h (IQR: 18.13–80.38) while the median duration of fever was 22.13 h (IQR 6.67–51.98). Duration of CB use was highly correlated with fever duration (Spearman's rho, 0.771, p < .001), moderately with length of stay (LOS) (rho, 0.425, p < .001), LOS after CB initiation (rho, 0.475, p < .001) and antipyretic use (rho, 0.506, p < .001). No other statistically significant correlations were observed. Conclusion: Documentation of CB use including temperature set points, time of discontinuation and duration in EMRs was poor. We could not establish benefits of CB use in this study but observed that almost a third of patients developed adverse effects in the form of shivering. Thus, adverse effects of CB use may outweigh potential benefits. Their use should be reevaluated and institutional protocols developed for their use.
AB - Background: The therapeutic benefits and rationale for treating fevers with external cooling methods remain unclear. We aimed to describe the clinical settings in which cooling blankets (CBs) are used. Design: We conducted a retrospective chart review of CB use in adult patients admitted to our tertiary care center over a one-year period. We measured how they are used and correlations between clinical variables and their duration of use. Results: 561 patients were included in our study. The mean highest temperature during hospitalization was 39.35 °C (SD, 0.67). Shivering occurred in 176 patients (31.4%) while on a CB although 303 patients (54%) had no data regarding shivering. Discontinuation of CBs was recorded in only 177 (30.5%) cases. Among these, the median duration of use was 33.37 h (IQR: 18.13–80.38) while the median duration of fever was 22.13 h (IQR 6.67–51.98). Duration of CB use was highly correlated with fever duration (Spearman's rho, 0.771, p < .001), moderately with length of stay (LOS) (rho, 0.425, p < .001), LOS after CB initiation (rho, 0.475, p < .001) and antipyretic use (rho, 0.506, p < .001). No other statistically significant correlations were observed. Conclusion: Documentation of CB use including temperature set points, time of discontinuation and duration in EMRs was poor. We could not establish benefits of CB use in this study but observed that almost a third of patients developed adverse effects in the form of shivering. Thus, adverse effects of CB use may outweigh potential benefits. Their use should be reevaluated and institutional protocols developed for their use.
KW - Blanket
KW - Cooling
KW - External
KW - Fever
KW - Shiver
UR - https://www.scopus.com/pages/publications/85118572230
U2 - 10.1016/j.amjms.2021.06.009
DO - 10.1016/j.amjms.2021.06.009
M3 - Article
C2 - 34161829
AN - SCOPUS:85118572230
SN - 0002-9629
VL - 362
SP - 601
EP - 605
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 6
ER -