Fever control using external cooling reduces early mortality in septic shock patients

February 17, 2012

Fever control using external cooling in sedated patients with septic shock is safe and decreases vasopressor requirements and early mortality, according to a new study from researchers in France.

"The benefits and risks of fever control in patients with severe remains a matter of ," said lead author Frédérique Schortgen, MD, PhD, of the Henri Mondor Hospital in Créteil, France. "In our study, external cooling to achieve normothermia in patients with septic shock was safe, accelerated hemodynamic stabilization, decreased vasopressor requirements, increased the rate of shock reversal, and decreased early ."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

In the multicenter trial, 200 febrile adults with from seven participating ICUs, all of whom were receiving vasopressor treatment, mechanical ventilation and sedation, were randomized to external cooling (n = 101) or no external cooling (n = 99). Patients underwent cooling for 48 hours to maintain a core body temperature between 36.5°C and 37°C. Vasopressors were tapered to maintain a mean arterial pressure target of 65 mmHg or more in both groups.

After two hours of treatment, body temperature was significantly lower in the cooling group. The percentage of patients with a 50 percent vasopressor dose decrease vs. baseline was significantly higher in the cooling group from 12 hours of treatment; this difference was not significant at 48 hours. Shock reversal during the ICU stay was significantly more common in the cooling group, as was day-14 mortality. All comparisons remained significant after adjustment for baseline vasopressor dose and sepsis severity scores.

The study had several limitations. Patients in the cooling group had a lower baseline dose of vasopressors, perhaps indicating lower illness severity, although all other variables associated with outcomes in sepsis were well balanced between the two treatment groups. In addition, the study was not blinded, and life-supporting treatments given before inclusion during the early stage of sepsis were not recorded.

"Although cooling prevented early deaths in our patients, mortality reduction was not significant at ICU or hospital discharge, and we cannot make definitive conclusions on the effects of cooling on mortality from our data" said Dr. Schortgen. "Larger studies are needed to confirm the positive effects of cooling on mortality we observed and to examine whether control provides any additional benefits in with severe sepsis."

Related Stories

Recommended for you

Antibody found that fight MERS coronavirus

July 28, 2015

(Medical Xpress)—An international team of researchers has found a MERS neutralizing antibody—a discovery that could perhaps lead to a treatment for people infected with the virus. In their paper published in Proceedings ...

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.