External Cooling Improves Outcomes in Septic Shock

External Cooling Improves Outcomes in Septic Shock
External Cooling Improves Outcomes in Septic Shock

(HealthDay News) – Use of external cooling to achieve fever control is safe for sedated patients in septic shock, and decreases vasopressor requirements and early mortality, according to a study published online Feb. 17 in the American Journal of Respiratory and Critical Care Medicine.

Frédérique Schortgen, MD, PhD, from the Groupe Hospitalier Henri Mondor in Créteil, France, and colleagues investigated whether fever control by external cooling reduces vasopressor requirements for patients in septic shock. Febrile patients were randomly allocated to external cooling (101 patients), to achieve normothermia for 48 hours, or no external cooling (99 patients). The primary end point was the proportion of patients who achieved a 50% decrease in vasopressor dose at 48 hours.

The researchers found that, after two hours of treatment, the body temperature was significantly lower in the cooling group. At 12 hours of treatment, a 50% decrease in the vasopressor dose was significantly more common with external cooling than with no cooling (54% vs. 20%; P<0.001), but the difference between the groups was not significant at 48 hours (72% vs. 61%). In the cooling group, shock reversal during the intensive care unit stay was significantly more common (86% vs. 73%; P=0.021). In addition, day-14 mortality was significantly lower in the cooling than the no-cooling group (19% vs. 34%; P=0.013).

"Fever control using external cooling in sedated patients with septic shock is safe and decreases vasopressor requirements and early mortality. Further larger studies are needed to confirm the positive signal of fever control on mortality and to determine whether mild hypothermia provides additional benefits," the authors write.

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