TY - JOUR
T1 - Body temperature and mortality in patients with acute respiratory distress syndrome
AU - The National heart, Lung, and Blood Institute Acute Respiratory distress syndrome Network
AU - Schell-Chaple, Hildy M.
AU - Puntillo, Kathleen A.
AU - Matthay, Michael A.
AU - Liu, Kathleen D.
AU - Wiedemann, Herbert P.
AU - Arroliga, Alejandro C.
AU - Fisher, Charles J.
AU - Komara, John J.
AU - Periz-Trepichio, Patricia
AU - Parsons, Polly E.
AU - Welsh, Carolyn
AU - Fulkerson, William J.
AU - Macintyre, Neil
AU - Mallatratt, Lee
AU - Sebastian, Mark
AU - Davies, John
AU - Van Dyne, Elizabeth
AU - Govert, Joseph
AU - Sevransky, Jonathan
AU - Murray, Stacey
AU - Brower, Roy G.
AU - Thompson, David
AU - Fessler, Henry E.
AU - Morris, Alan H.
AU - Clemmer, Terry
AU - Davis, Robin
AU - Orme, James
AU - Weaver, Lindell
AU - Grissom, Colin
AU - Thomas, Frank
AU - Gleich, Martin
AU - Lawton, Charles
AU - D'hulst, Janice
AU - Peerless, Joel R.
AU - Smith, Carolyn
AU - Kallet, Richard
AU - Luce, John M.
AU - Gottlieb, Jonathan
AU - Park, Pauline
AU - Girod, Aimee
AU - Yannarell, Lisa
AU - Eisner, Mark D.
AU - Daniel, Brian
AU - Abraham, Edward
AU - Piedalue, Fran
AU - Jagusch, Rebecca
AU - Miller, Paul
AU - McIntyre, Robert
AU - Greene, Kelley E.
AU - Silverman, Henry J.
N1 - Publisher Copyright:
© 2015 American Association of Critical-Care Nurses.
PY - 2015
Y1 - 2015
N2 - Background: 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. Objective: To examine the relationship between body temperature and mortality in patients with ARDS. Methods: 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. Results: 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). Conclusions: 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.
AB - Background: 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. Objective: To examine the relationship between body temperature and mortality in patients with ARDS. Methods: 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. Results: 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). Conclusions: 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.
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U2 - 10.4037/ajcc2015320
DO - 10.4037/ajcc2015320
M3 - Article
C2 - 25554550
AN - SCOPUS:84961340220
SN - 1062-3264
VL - 24
SP - 15
EP - 23
JO - American Journal of Critical Care
JF - American Journal of Critical Care
IS - 1
ER -