Zaaqoq, AM and Yende, S
(2013)
A touch of cooling may help.
Critical Care, 17 (2).
ISSN 1364-8535
Abstract
Background: Fever control may improve vascular tone and decrease oxygen consumption; however, fever may help combat infection.Methods: Results: There were 200 patients randomized, 101 to the cooling group and 99 to the no-cooling group. The percentage of patients with a 50% vasopressor dose decrease versus baseline was not significantly different at 48 hours of treatment (72% vs. 61%; absolute difference, 11%; 95% confidence interval (CI), -23 to 2; P = 0.4), although it was at 12 hours (54% vs. 20%; absolute difference, 34%; 95% CI, -46 to -21; P < 0.001). External cooling significantly reduced the number of patients needing a vasopressor dose increase (34% vs. 52%; absolute difference, -18%; 95% CI, -4 to -31%; P = 0.011) and significantly increased the shock reversal during the study period (86% vs. 73%; absolute difference, 13%; 95% CI, 2 to 25%; P = 0.021). Day 14 mortality was significantly lower in the cooling group (19% vs. 34%; absolute difference, -16%; 95% CI, -28 to -4; P = 0.013), but mortality was not different at ICU and hospital discharge.Conclusions: Fever control using external cooling was safe, and decreased vasopressor requirements and early mortality in septic shock. © 2013 BioMed Central Ltd.
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