Interventions of Kimberger et al for Setting the Body's Shivering Threshold to a Lower Temperature in a Patient Undergoing Therapeutic Hypothermia

 

Interventions that can reduce the body temperature at which shivering is triggered:

(1) therapy with moderate doses of meperidine (Demerol) in combination with

(2) skin surface warming

 

Dosing target for meperidine: plasma concentration 0.9 µg/mL

 

The combination was used to reduce the shivering threshold to just under 34°C, with minimal sedation and no respiratory depression.

 

Absolute contraindications to use of meperidine:

(1) hypersensitivity to meperidine

 

Relative contraindication to use of meperidine, or reasons for discontinuation:

(1) renal insufficiency (results in accumulation of the toxic metabolite norpethidine)

(2) toxicity due to prolonged or high dose therapy