Association between hypothermia and hyperthermia and 28-day mortality in pediatric intensive care unit patients: a

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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

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Jie Chang1,2, Liping Liu2, Zhiying Han3,4

  • 1Department of Pediatrics, Shanxi Medical University, Taiyuan, 030000, China.

Scientific Reports
|March 18, 2025
PubMed

Insights

Admission body temperature abnormalities in pediatric intensive care units (PICUs) are linked to increased mortality risk. Both severe hypothermia and hyperthermia independently predict higher 28-day mortality in critically ill children.

Area of Science:

  • Pediatrics
  • Critical Care Medicine
  • Physiology

Background:

  • Body temperature (BT) monitoring is crucial for critically ill patients.
  • Abnormal BT in intensive care units (ICUs) correlates with adverse outcomes.
  • Limited data exists on admission BT and mortality in pediatric intensive care units (PICUs).

Purpose of the Study:

  • To investigate the association between admission body temperature and 28-day mortality in pediatric intensive care patients.
  • To identify specific temperature thresholds impacting pediatric mortality.
  • To analyze the relationship between temperature dysregulation and survival in critically ill children.

Main Methods:

  • Retrospective analysis of the Pediatric Intensive Care (PIC) database (7,350 patients).
  • Assessment of 28-day, 90-day, and in-hospital mortality as outcomes.
  • Multivariate Cox regression and smooth curve fitting to analyze BT and mortality relationship.

Main Results:

  • The 28-day mortality rate in the PICU cohort was 3.5%.
  • Severe hypothermia (HR 1.89) and severe hyperthermia (HR 1.97) were independent risk factors for 28-day mortality.
  • A U-shaped correlation between BT and 28-day mortality was observed, with an inflection point at 37.2°C.

Conclusions:

  • Abnormal admission body temperature, both hypothermia and hyperthermia, significantly increases mortality risk in pediatric intensive care patients.
  • The severity of temperature deviation from normal is directly associated with increased mortality.
  • Maintaining normothermia upon admission may improve outcomes for critically ill children.

Keywords:
Intensive care unitsPediatricRisk factors

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