Contributor: Adam Barkin, MD

Educational Pearls:

• Fever is an adaptive response to infection, but elderly and immunocompromised patients may not be able to mount a hyperthermic response in sepsis
• Patients with fever in sepsis end up receiving treatment earlier and have better outcomes
• Hypothermic patients with severe sepsis admitted to the ICU had a 32% mortality versus 21% mortality in those who had a fever on presentation
• 3-hour sepsis bundle compliance was less frequent in hypothermic patients than in febrile patients (56% versus 71%)
• Early broad spectrum antibiotics were administered less in patients who were hypothermic than those that were febrile (77% versus 87%)

References

Blair E, Buxton RW, Cowley RA, Mansberger AR. The Use of Hypothermia in Septic Shock. JAMA. 1961;178(9):916–919. doi:10.1001/jama.1961.73040480005008b

Kushimoto S, Abe T, Ogura H, et al. Impact of Body Temperature Abnormalities on the Implementation of Sepsis Bundles and Outcomes in Patients With Severe Sepsis: A Retrospective Sub-Analysis of the Focused Outcome Research on Emergency Care for Acute Respiratory Distress Syndrome, Sepsis and Trauma Study. Crit Care Med. 2019;47(5):691-699.

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD

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