A comparison between the effectiveness of active cooling and sponge cooling in decreasing body temperature of febrile patients in intensive care units Print

Fever is of the commonest problemsof intensive care unit patients. Fever management reduces metabolic activity and oxygen demand, and thereby mortality will be reduced. Physical methods of temperature reduction can decrease body temperature in a short time, but their effectiveness and side-effects are not the same in different patients especially the highly sick ones. This study compared the effectiveness of active cooling and sponge cooling in decreasing body temperature of febrile patients in intensive care units.

This randomized clinicaltrialwas done on 57 patientsadmitted to intensive care units of educational-care centers in Qazvin and Tehran. Patients were selected by stratified block randomization and divided into sponge and active cooling groups. Samples were subjected to three hours of intervention. The data were analyzed repeated measurement ANOVA and Kaplan-Meier survival analysis using SPSS software at 0.05.

There was no statistically significant difference between the two groups in terms of age, gender, body surface area, and body mass index. After three hours of intervention, the mean and standard deviation of temperature reduced from 38.7 ± 0.21 to 37.6 ± 0.55degrees centigrade in the active cooling group and from 38.8 ± 0.25 to 37.1 ± 0.18 in the sponge cooling group (P<0.01). A fter 120 minutes of intervention, mean temperature in the active cooling group was significantly lower than that of the sponge cooling group (P<0.01). A fter 180 minutes of intervention, 100% of patients in the active cooling group experienced 1 degree cooler body temperature while in the sponge cooling group, only 65% had the same experience (P<0.02). Both methods, irrespective of acetaminophen dose received,reduced body temperature in a significant way (P<0.02), and the acetaminophen dose had no confounding effect.

Sponge method is an effective way to control the temperature, but the rate of temperature reduction in this method is less than that of the active method. Active cooling method was considered a better way for the rapid fever control, because this method reduced the temperature with a less fluctuating but faster speed than sponging. Hence, a more accurate estimate for the time to achieve the desired therapeutic response is provided for health providers.