• Am. J. Med. Sci. · Dec 2021

    Cooling Blankets in Hospitalized Patients: Time to Reevaluate.

    • Thomas Chen, Prashant Malhotra, Aradhana Khameraj, Nelda Ong-Bello, Pooja P Vyas, Rehana Rasul, Rebecca M Schwartz, and Bruce F Farber.
    • Jane and Dayton Brown Division of Infectious Diseases at the Barbara and Donald Zucker School of Medicine at Northwell/Hofstra University, Manhasset, New York. Electronic address: tchen10@northwell.edu.
    • Am. J. Med. Sci. 2021 Dec 1; 362 (6): 601-605.

    BackgroundThe 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.DesignWe 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.Results561 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.ConclusionDocumentation 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.Copyright © 2021. Published by Elsevier Inc.

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