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Ther Hypothermia Temp Manag. 2019 Mar;9(1):70-75. doi: 10.1089/ther.2017.0057. Epub 2018 May 15.

Independent Risk Factors for the Shivering Occurrence During Induction Period in Out-of-Hospital Cardiac Arrest Survivors Treated with Targeted Temperature Management.

Author information

1
1 Department of Emergency Medicine, University of Ulsan College of Medicine , Asan Medical Center, Seoul, Korea.
2
2 Department of Outpatient Nursing Team II, Asan Medical Center , Seoul, Korea.

Abstract

The occurrence of shivering during the induction period of targeted temperature management (TTM) remains a therapeutic obstacle, which delays the achievement of target temperature. The aim of this study was to identify risk factors leading to shivering during the induction period. We analyzed a prospective cohort of adult out-of-hospital cardiac arrest (OHCA) survivors treated with TTM from January 2015 to June 2017. Patients who developed shivering during the induction period were compared to those who did not. Multivariable analysis was performed to determine risk factors of shivering. Among 80 patients treated with TTM, shivering occurred in 22 patients (27.5%). In the shivering group, the time to achieve target temperature was significantly delayed (245 minutes vs. 151 minutes, pā€‰=ā€‰0.005). Multivariable analysis showed that being underweight (OR, 18.40; 95% CI, 1.89-179.19) or overweight (OR, 8.65; 95% CI, 1.60-46.80), age <65 years (OR, 5.54; 95% CI, 1.25-16.12), and duration of cardiac arrest <20 minutes (OR, 4.50; 95% CI, 1.25-16.12) were predictors for the occurrence of shivering. OHCA patients with abnormal body weight, age <65 years, and duration of cardiac arrest <20 minutes should be monitored thoroughly for early recognition of shivering.

KEYWORDS:

cardiac arrest; postcardiac arrest syndrome; shivering; targeted temperature management; therapeutic hypothermia

PMID:
29762083
DOI:
10.1089/ther.2017.0057

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