Associations Between Core Temperature Disorders and Outcomes of Pediatric Intensive Care Unit Patients

Area of Science:

• Pediatric critical care medicine
• Thermoregulation in critically ill children
• Clinical outcomes research

Background:

• Limited research exists on fever and outcomes in pediatric intensive care units (PICUs), with conflicting findings.
• Associations between hypothermia and patient outcomes in PICU settings remain largely unstudied.

Purpose of the Study:

• To determine the incidence and characteristics of fever and hypothermia in PICU patients.
• To investigate the associations between fever, hypothermia, and adverse outcomes, including prolonged mechanical ventilation, extended PICU stay, and mortality.

Main Methods:

• Prospective study of 545 patients admitted to two PICUs over two years.
• Core body temperature measured via rectal or axillary thermometry; fever defined as >38.0°C, hypothermia as <36.0°C.
• Statistical analyses (univariate and multivariate) used to evaluate associations between temperature disorders and adverse outcomes.

Main Results:

• Fever occurred in 54.9% and hypothermia in 29.5% of patients.
• Both fever and hypothermia were independently associated with prolonged mechanical ventilation and PICU stay (P < .001).
• Fever magnitude/duration and hypothermia's infectious cause were linked to longer PICU stays and increased mortality.

Conclusions:

• Fever and hypothermia are significant predictors of adverse outcomes in PICU patients.
• The manifestation and specific characteristics of temperature dysregulation are crucial factors in patient prognosis.
• Findings underscore the importance of monitoring and managing temperature disturbances in critically ill children.