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Updated: Jul 25, 2025

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Targeted temperature management at 36°C is a risk factor for ventilator-associated pneumonia
Masaru Nasuno1,2, Yukari Yokoyama3, Mitsuo Motobayashi2,4,5,6
1Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan.
Background:
In contrast to the adult population, limited information is currently available on risk factors for ventilator-associated pneumonia (VAP) in children. Therapeutic hypothermia has been identified as a risk factor for the early onset of VAP in adults; however, the relationship between VAP and normothermia remains unclear. The present study investigated risk factors for VAP in children, with a focus on the deleterious effects of therapeutic normothermia on VAP.
Methods:
We retrospectively investigated the clinical characteristics of children treated with mechanical ventilation for more than 48 h and analyzed risk factors for VAP. The endpoint was the onset of VAP by the seventh day after the initiation of mechanical ventilation.
Results:
Among the 288 patients enrolled, seven (2.4%) developed VAP. No significant differences were observed in clinical backgrounds between the VAP and non-VAP groups. A univariate analysis identified target temperature management (TTM) at 36°C (p < 0.0001) and methylprednisolone (mPSL) pulse therapy (p = 0.02) as risk factors for VAP. An analysis of the time to the onset of VAP by the Kaplan-Meier plot and log-rank test revealed a significantly higher incidence of VAP in the TTM group (p < 0.0001) and mPSL pulse group (p = 0.001).
Conclusion:
TTM at 36°C and mPSL pulse therapy may be risk factors for VAP in the pediatric population.
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