USE AND EFFECTIVENESS OF HYPOTHERMIA BLANKETS FOR FEBRILE PATIENTS INTHE INTENSIVE-CARE UNIT

We performed a prospective observational (noninterventional) study of hypothermia blanket use in a population of adult intensive care unit p atients with body temperatures of greater than or equal to 102.5 degre es F. Thirty-nine of ninety-four febrile episodes (in 83 patients) wer e treated with hypothermia blankets. Logistic regression revealed that the strongest independent predictors of hypothermia blanket use were a temperature of greater than or equal to 103.5 degrees F (odds ratio [OR] = 17), mechanical ventilation (OR = 25), and acute central nervou s system illness (OR = 7.5). Hospitalization in the medical intensive care unit was strongly associated with avoidance of this therapy (OR = 0.023). Treatment with a hypothermia blanket was ordered by a physici an in only 15% of cases. The mean cooling rate was the same (0.028 deg rees F/h) for blanket-treated and control patients. Multivariate Cox r egression and factorial and repeated measures of analysis of variance revealed that blanket treatment was not more effective than other cool ing methods. However, this treatment was associated with more ''zigzag '' temperature fluctuations of greater than or equal to 3 degrees F (5 6% of blanket-treated patients vs. 18% of control patients; P <.001) a nd rebound hypothermia (18% vs. 0; P =.001). Hypothermia blanket thera py is primarily a nursing decision. We conclude that in addition to be ing no more effective than other cooling measures, hypothermia blanket therapy was associated with more temperature fluctuations and with mo re episodes of rebound hypothermia.