Effects of target temperature management on the outcome of septic patients with fever

Abstract

Objectives. To investigate the effects of target temperature management on hemodynamic changes, inflammatory and immune factors, and clinical outcomes of sepsis patients with fever. Methods. Patients diagnosed with sepsis with a core temperature of ≥39°C were randomly divided into two groups: a low-temperature group (LT group: 36.5°C-38°C) and a high-temperature group (HT group: 38.5°C-39.5°C). A target core temperature was achieved within 6 hrs posttreatment and maintained for 24 hrs. Then, the hemodynamic changes, inflammatory and immune factors, and clinical outcomes were evaluated. Results. Compared with the HT group, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) showed a significant decrease in the LT group (P<0.05). In contrast, IL-4 and IL-10 were higher in the LT group than in the HT group (P<0.05). The CD4-T lymphocyte (CD4+), CD8-T lymphocyte (CD8+), and monocytic human leukocyte antigen-DR (mHLA-DR) in the LT group were higher than in the HT group (P<0.05). The ICU stay and the anti-infection treatment costs were higher in the LT group (P<0.05). Conclusion. Low-temperature management of patients resulted in a low level of proinflammatory cytokines. Excessive temperature control in sepsis patients with fever may be harmful.