{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:08:16Z","timestamp":1777939696614,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T00:00:00Z","timestamp":1581292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Hypothermia and Temperature Management"],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:p>\n                    Intravenous nonsteroidal anti-inflammatory drugs and nonopioid analgesics are used to achieve normothermia or relieve pain in patients with aneurysmal subarachnoid hemorrhage (aSAH). We investigated the effects of paracetamol (1\u2009g), diclofenac (75\u2009mg) and metamizole (1\u2009g) on systemic and cerebral hemodynamics and temperature during febrile and nonfebrile episodes after aSAH. Prospectively collected data from 77 consecutive poor-grade aSAH patients with invasive neuromonitoring were included. The burden and occurrence of hypotension (mean arterial pressure &lt;70\u2009mmHg), brain tissue hypoxia (P\n                    <jats:sub>bt<\/jats:sub>\n                    O\n                    <jats:sub>2<\/jats:sub>\n                    &lt; 20\u2009mmHg), high intracranial pressure (&gt;22\u2009mmHg), low cerebral perfusion pressure (CPP &lt;70\u2009mmHg), and cerebral autoregulation pressure (pressure reactivity index [PRx]) during baseline (1 hour before) and 6 hours after medication were analyzed in febrile (core temperature; T\n                    <jats:sub>core<\/jats:sub>\n                    \u2265 38.3\u00b0C) and nonfebrile episodes. Nine hundred eighty-nine infusions (278 paracetamol, 542 diclofenac, and 169 metamizole) were administered resulting in significant reduction of core and brain temperature during febrile (49%) and nonfebrile (51%) episodes (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In febrile cases, temperature decreased for &gt;1 hour below 37.5\u00b0C in 36% of interventions and \u226437\u00b0C in 11%. Hemodynamic side effects with hypotension and low CPP occurred in both febrile and nonfebrile episodes (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) prompting increased vasopressor support in 31% of cases, even more pronounced during the vasospasm period (4\u201312 days postictus) (OR 5.4, 95% CI 1.8\u201316). The magnitude of P\n                    <jats:sub>bt<\/jats:sub>\n                    O\n                    <jats:sub>2<\/jats:sub>\n                    -decrease is directly correlated with the decrease in T\n                    <jats:sub>core<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.002) and higher baseline P\n                    <jats:sub>bt<\/jats:sub>\n                    O\n                    <jats:sub>2<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). PRx decreased in febrile and nonfebrile episodes (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), indicating improvement of cerebrovascular autoregulation. Antipyretics were insufficient to achieve sustained normothermia in poor-grade aSAH patients. Hemodynamic side effects were common even when given as analgesic drugs. Further studies are needed to weigh hemodynamic side effects to benefits (inter alia improved cerebral autoregulation).\n                  <\/jats:p>","DOI":"10.1089\/ther.2018.0046","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T11:58:11Z","timestamp":1551787091000},"page":"27-36","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["An Observational Study on the Use of Intravenous Non-Opioid Analgesics and Antipyretics in Poor-Grade Subarachnoid Hemorrhage: Effects on Hemodynamics and Systemic and Brain Temperature"],"prefix":"10.1177","volume":"10","author":[{"given":"Bogdan","family":"Ianosi","sequence":"first","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."},{"name":"Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Rass","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Gaasch","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Huber","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Lindner","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner O.","family":"Hackl","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Kofler","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alois Josef","family":"Schiefecker","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma","family":"Almashad","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."},{"name":"Faculty of Medicine, Alexandria University, Alexandria, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronny","family":"Beer","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Pfausler","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimund","family":"Helbok","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,2,10]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)64885-4"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181aa5e8d"},{"key":"e_1_3_3_4_1","first-page":"481","article-title":"Targeted temperature management in the ICU: guidelines from a French expert panel","volume":"37","author":"Botte A","year":"2018","unstructured":"Botte A, , Cariou A, , Payen J, et al. Targeted temperature management in the ICU: guidelines from a French expert panel. Anaesth Crit Care Pain Med, 2018; 37:481\u2013491.","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"2","key":"e_1_3_3_5_1","first-page":"S282","article-title":"The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a list of recommendations and additional conclusions","author":"Care N","year":"2014","unstructured":"Care N, , Sherry C, , Jan C, et al. The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a list of recommendations and additional conclusions. Neurocrit Care, 2014; Suppl 2:S282\u2013S296.","journal-title":"Neurocrit Care"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21100"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000047344.28843.EB"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3182587839"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051203"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-017-0389-4"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199707000-00005"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9605-9"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1293-6"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2002.11.1.38"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000258543.45879.f5"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000218821.34014.1B"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000311064.18368.EA"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003016"},{"key":"e_1_3_3_19_1","doi-asserted-by":"crossref","unstructured":"Harrigan MR Newell DW Alexandrov AV. Cerebral vasospasm after subarachnoid hemorrhage. In: Cerebrovascular Ultrasound in Stroke Prevention and Treatment Second Edition. Blackwell Publishing Ltd. 2011: pp. 207\u2013213. https:\/\/onlinelibrary.wiley.com\/doi\/book\/10.1002\/9781444327373.","DOI":"10.1002\/9781444327373.ch12"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-017-1347-6"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-014-1777-8"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1968.28.1.0014"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000218413.51546.9E"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2014.12.059"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009734.2017.1319440"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318169eda9"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.10.1299"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-014-2129-2"},{"key":"e_1_3_3_29_1","doi-asserted-by":"crossref","unstructured":"Picetti E Oddo M Prisco L et al. A survey on fever monitoring and management in patients with acute brain injury: the SUMMA study. 2018. [Epub ahead of print]; DOI: 10.1097\/ANA.0000000000000536.","DOI":"10.1097\/ANA.0000000000000536"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2005.103.6.0974"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9537-4"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9588-6"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc12714"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/30.10.1646"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1513-1"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2012.02.003"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/23328940.2015.1102802"}],"container-title":["Therapeutic Hypothermia and Temperature Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/ther.2018.0046","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/ther.2018.0046","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/ther.2018.0046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:25:16Z","timestamp":1777699516000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/ther.2018.0046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,10]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,3,1]]}},"alternative-id":["10.1089\/ther.2018.0046"],"URL":"https:\/\/doi.org\/10.1089\/ther.2018.0046","relation":{},"ISSN":["2153-7658","2153-7933"],"issn-type":[{"value":"2153-7658","type":"print"},{"value":"2153-7933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,10]]}}}