Effects of Peripheral Cold Application on Core Body Temperature and Hemodynamic Parameters in Febrile Patients in the Neurosurgical ICU

Wednesday, 1 August 2012: 11:10 AM

H. Asgar Pour, PhD, RN
School of Aydın Health, University of Adnan Menderes, Aydın, Turkey
M. Yavuz, PhD, RN
Surgical nursing, Ege university, Izmir, Turkey

Learning Objective 1: How fever affects on hemodynamic parameters, changes of hemodynamic parameters during fever and nursing initiatives related to these changes.

Learning Objective 2: Effects of PCA on hemodynamic parameters will be of benefit to the quality and efficacy of care.

Purpose: To investigate the effects of fever on hemodynamic parameters and effects of peripheral cold application (PCA) on core body temperature (CBT) and hemodynamic parameters in febrile patients in the neurosurgical ICU (NICU).  

Methods: This study was an experimental, repeated-measures performed in the NICU. The research sample included all patients with fever in postoperative period. PCA was performed for 20 min. CBT and hemodynamic parameters were measured at admission, 1 h before the onset of fever, before, immediately after and 30 min after the end of PCA.  

Results: During fever, systolic blood pressure (SBP), mean arterial blood pressure (MAP) and  arterial oxygen saturation (O2Sat) decreased by 5.07 ± 7.89 mmHg, 0.191 ± 6.00 mmHg, and 0.742% ± 0.97%, respectively, whereas the pulse rate and diastolic blood pressure (DBP) increased by 8.528 ± 4.42 beats/per min and 1.842 ± 6.9 mmHg, respectively. Immediately after PCA, CBT decreased by 0.3°C, and pulse rate, SBP, DBP, MAP, and O2Sat increased by 3.3 beats/per min, 1.40 mmHg, 1.87 mmHg, 0.98 mmHg, and 0.27%, respectively. Thirty minutes after the end of PCA, CBT, DBP, MAP, and pulse rate decreased by 0.57°C, 0.34 mmHg, 0.60 mmHg, and increased by 0.98 mmHg and 0.04%, respectively.

Conclusion: A degree celsius (1ºC) increase in core body temperature was decline of 4.43 mmHg in systolic blood pressure , 0.166 mmHg mean arterial blood pressure and 0.64% O2Sat and increase of 1.61 mmHg in diastolik arterial blood pressure and 7.46 beats/per min pulse rate. According to these results, changes in hemodynamic parameters occur during elevations in core body temperature. PCA increases SBP, DBP, MAP, and O2Sat and decreases CBT and pulse rate. Thus, accurate and careful measurements of hemodynamic parameters play an important role in preventing complications before, during, and after nursing interventions related to fever.