Body temperature and mortality in patients with acute respiratory distress syndrome.

TitleBody temperature and mortality in patients with acute respiratory distress syndrome.
Publication TypeJournal Article
Year of Publication2015
AuthorsSchell-Chaple HM, Puntillo KA, Matthay MA, Liu KD
Corporate AuthorsNational Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network
JournalAm J Crit Care
Volume24
Issue1
Pagination15-23
Date Published2015 Jan
ISSN Number1937-710X
KeywordsBody Temperature, Female, Hospital Mortality, Humans, Male, Middle Aged, Respiratory Distress Syndrome, Adult, Survival Rate
Abstract

<p><b>BACKGROUND: </b>Little is known about the relationship between body temperature and outcomes in patients with acute respiratory distress syndrome (ARDS). A better understanding of this relationship may provide evidence for fever suppression or warming interventions, which are commonly applied in practice.</p><p><b>OBJECTIVE: </b>To examine the relationship between body temperature and mortality in patients with ARDS.</p><p><b>METHODS: </b>Secondary analysis of body temperature and mortality using data from the ARDS Network Fluid and Catheter Treatment Trial (n = 969). Body temperature at baseline and on study day 2, primary cause of ARDS, severity of illness, and 90-day mortality were analyzed by using multiple logistic regression.</p><p><b>RESULTS: </b>Mean baseline temperature was 37.5°C (SD, 1.1°C; range, 27.2°C-40.7°C). At baseline, fever (≥ 38.3°C) was present in 23% and hypothermia (< 36°C) in 5% of the patients. Body temperature was a significant predictor of 90-day mortality after primary cause of ARDS and score on the Acute Physiology and Chronic Health Evaluation III were adjusted for. Higher temperature was associated with decreased mortality: for every 1°C increase in baseline temperature, the odds of death decreased by 15% (odds ratio, 0.85; 95% CI, 0.73-0.98, P = .03). When patients were divided into 5 temperature groups, mortality was lower with higher temperature (P for trend = .02).</p><p><b>CONCLUSIONS: </b>Early in ARDS, fever is associated with improved survival rates. Fever in the acute phase response to lung injury and its relationship to recovery may be an important factor in determining patients' outcome and warrants further study.</p>

DOI10.4037/ajcc2015320
Alternate JournalAm. J. Crit. Care
PubMed ID25554550
PubMed Central IDPMC4464553
Grant ListN01 HR016146 / HR / NHLBI NIH HHS / United States
N01-HR 46046-64 / HR / NHLBI NIH HHS / United States
N01-HR-16146-54 / HR / NHLBI NIH HHS / United States