• Critical care nurse · Dec 2011

    Optimal management of shivering during therapeutic hypothermia after cardiac arrest.

    • Angela Logan, Prasama Sangkachand, and Marjorie Funk.
    • Yale School of Nursing, Yale University, New Haven, Connecticut 06536-0740, USA. angela.logan@yale.edu
    • Crit Care Nurse. 2011 Dec 1;31(6):e18-30.

    AbstractBoth 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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