J Korean Med Sci.  2016 Dec;31(12):2033-2041. 10.3346/jkms.2016.31.12.2033.

The Association of Fever with Total Mechanical Ventilation Time in Critically Ill Patients

• Park DW
• Egi M
• Nishimura
• Chang Y
• Suh GY
• Lim CM
• Kim JY
• Tada K
• Matsuo K
• Takeda S
• Tsuruta R
• Yokoyama T
• Kim SO
• Koh Y
• Fever and Antipyretic in Critically ill patients Evaluation (FACE) Study Group in Japan-Korea Intensive Care Study (JAKOICS) Group

• KMID: 2355636
• DOI: http://doi.org/10.3346/jkms.2016.31.12.2033

Abstract

This research aims to investigate the impact of fever on total mechanical ventilation time (TVT) in critically ill patients. Subgroup analysis was conducted using a previous prospective, multicenter observational study. We included mechanically ventilated patients for more than 24 hours from 10 Korean and 15 Japanese intensive care units (ICU), and recorded maximal body temperature under the support of mechanical ventilation (MAX(MV)). To assess the independent association of MAX(MV) with TVT, we used propensity-matched analysis in a total of 769 survived patients with medical or surgical admission, separately. Together with multiple linear regression analysis to evaluate the association between the severity of fever and TVT, the effect of MAX(MV) on ventilator-free days was also observed by quantile regression analysis in all subjects including non-survivors. After propensity score matching, a MAX(MV) ≥ 37.5℃ was significantly associated with longer mean TVT by 5.4 days in medical admission, and by 1.2 days in surgical admission, compared to those with MAX(MV) of 36.5℃ to 37.4℃. In multivariate linear regression analysis, patients with three categories of fever (MAX(MV) of 37.5℃ to 38.4℃, 38.5℃ to 39.4℃, and ≥ 39.5℃) sustained a significantly longer duration of TVT than those with normal range of MAX(MV) in both categories of ICU admission. A significant association between MAX(MV) and mechanical ventilator-free days was also observed in all enrolled subjects. Fever may be a detrimental factor to prolong TVT in mechanically ventilated patients. These findings suggest that fever in mechanically ventilated patients might be associated with worse mechanical ventilation outcome.

Keyword

Body Temperature; Intensive Care Units; Mechanical Ventilation; Fever

MeSH Terms

Asian Continental Ancestry Group
Body Temperature
Critical Illness*
Fever*
Humans
Intensive Care Units
Linear Models
Observational Study
Propensity Score
Prospective Studies
Reference Values
Respiration, Artificial*

Figure

• 

  Fig. 1 Study design in survived subjects. MV = mechanical ventilation, MAXMV = maximum body temperature during MV.

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