First Use of a New Device for Administration of Buspirone and Acetaminophen to Suppress Shivering during Therapeutic Hypothermia

Akilesh Honasoge, Braden Parker, Kelly Wesselhoff, Neal Lyons, Erik Kulstad

Research output: Contribution to journalArticle

5 Scopus citations


Therapeutic hypothermia or targeted temperature management has been used after cardiac arrest to improve neurological outcomes and mortality. However, a side effect of temperature modulation is a centrally mediated shivering response. The Columbia Anti-Shivering Protocol sets up a systematic method of intravenous (IV) and oral medication escalation to suppress this response and preserve the benefits of this therapy. We present the case of a 59-year-old male who began shivering after therapeutic hypothermia for cardiac arrest, leading to a persistent rise in core temperature despite adequate sedation. He was also found to have gastric contents similar to coffee grounds through nasogastric tube suction. The shivering was effectively suppressed and the rising core temperature plateaued using rectal acetaminophen and buspirone administered by means of a novel device, the Macy Catheter. Also, when used in conjunction with other protocol-driven medications, the patient was able to achieve a core temperature of 33°C. The Macy Catheter appears to be a useful approach to rectally administer buspirone and acetaminophen, using an easy-to-place, nonsterile atraumatic device that requires no radiographic confirmation of placement.

Original languageEnglish (US)
Pages (from-to)48-51
Number of pages4
JournalTherapeutic hypothermia and temperature management
Issue number1
Publication statusPublished - Jan 1 2016


ASJC Scopus subject areas

  • Medicine(all)
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

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