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Fever control using external cooling in septic shock: a randomized controlled trial.
Frédérique Schortgen1, Karine Clabault, Sandrine Katsahian
1Service de Réanimation Médicale, CHU Henri Mondor, 94000 Créteil, France. frederique.schortgen@hmn.aphp.fr
American Journal of Respiratory and Critical Care Medicine
|February 28, 2012
Summary
External cooling effectively reduced vasopressor needs and early mortality in patients with septic shock. This fever control method proved safe and beneficial for improving outcomes in critically ill patients.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Physiology
Background:
- Fever control in septic shock may improve vascular tone and reduce oxygen demand.
- However, fever plays a role in combating infection.
Purpose of the Study:
- To investigate if external cooling to control fever reduces vasopressor requirements in patients with septic shock.
Main Methods:
- A multicenter randomized controlled trial involved febrile septic shock patients requiring vasopressors.
- Patients were assigned to external cooling to achieve normothermia or no cooling for 48 hours.
- The primary endpoint was a 50% decrease in vasopressor dose at 48 hours.
Main Results:
- External cooling significantly lowered body temperature and vasopressor dose requirements starting from 12 hours.
- Shock reversal was more frequent in the cooling group (86% vs. 73%).
- Day-14 mortality was significantly reduced with external cooling (19% vs. 34%).
Conclusions:
- Fever control with external cooling is safe in septic shock.
- External cooling decreases vasopressor needs and early mortality in septic shock patients.
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