Effectiveness of different targeted temperature management methods for fever in patients with acute cerebral infarction

Abstract

Objectives: To observe the effectiveness of different targeted temperature management (TTM) methods in patients with acute cerebral infarction (ACI) and explore the most feasible cooling strategies for ACI. Methods: We retrospectively analyzed the effectiveness of different TTM strategies for ACI patients treated in the Neuointensive Care Unit of South Hospital of Southern Medical University from June 1, 2012 to May 31, 2015. Patients were divided into four groups according to the presence or absence of fever and the cooling method: control group (n=63, normal body temperature), group A (ibuprofen alone, n=53), group B (ice bag alone, n=49), and group AB (ibuprofen + ice bag, n=62). We measured rectal temperature at admission and 1 h, 2 h, 4 h, 6 h, 12 h, 48 h and 72 h after admission in the control group. In groups A, B, and AB, we measured rectal temperature immediately after cooling and 1 h, 2 h, 4 h, 6 h, 12 h, 48 h, and 72 h after cooling. Results: Body temperature showed no significant difference immediately after cooling among groups A, B, and AB (P>0.05); however, cooling effectiveness was significantly different at multiple time points after cooling (P<0.05). Body temperature decrease was greater in group A, in which cooling effectiveness was more obvious. During cooling, body temperature in group B was slightly lower than that in group A, but the difference was not statistically significant. After cooling, body temperature decrease was significantly greater in group A than in groups B and AB (P<0.05). Conclusion: For ACI patients, ibuprofen alone is superior to ice-bag cooling or ibuprofen + ice bag cooling.