Document Detail


Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group.
MedLine Citation:
PMID:  1395659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the consequences of clinical hypothermia associated with sepsis syndrome and septic shock. DESIGN: Analysis of data from a multi-institutional, randomized, placebo-controlled, prospective study with predetermined end-point analysis of development of shock, recovery from shock, hospital length of stay, and death. SETTING: Multi-institutional medical and surgical ICUs. PATIENTS: Patients meeting predetermined criteria for severe sepsis syndrome. INTERVENTIONS: Appropriate sepsis and shock care with 50% of patients receiving methylprednisolone and 50% receiving placebo. MEASUREMENTS AND MAIN RESULTS: The occurrence rate of hypothermia (< 35.5 degrees C) is 9% in this population. When compared with febrile patients, hypothermic patients had a higher frequency of central nervous system dysfunction (88% vs. 60%), increased serum bilirubin concentration (35% vs. 15%), prolonged prothrombin times (50% vs. 23%), shock (94% vs. 61%), failure to recover from shock (66% vs. 26%), and death (62% vs. 26%). The hypothermic patients were also more likely to be classified as having a rapidly or ultimately fatal disease upon study admission. CONCLUSIONS: This prospective study confirms that hypothermia associated with sepsis syndrome has a significant relationship to outcome manifest by increased frequency of shock and death from shock. This finding is in sharp contrast to the protective effects of induced hypothermia in septic animals and perhaps man.
Authors:
T P Clemmer; C J Fisher; R C Bone; G J Slotman; C A Metz; F O Thomas
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  20     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-11-06     Completed Date:  1992-11-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1395-401     Citation Subset:  AIM; IM    
Affiliation:
Division of Critical Care Medicine, LDS Hospital, Salt Lake City, UT.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bilirubin / blood
Fever / epidemiology,  etiology
Humans
Hypothermia / etiology,  mortality*,  physiopathology
Intensive Care Units
Length of Stay / statistics & numerical data
Methylprednisolone / therapeutic use*
Middle Aged
Prognosis
Prospective Studies
Prothrombin Time
Risk Factors
Sepsis / complications*,  drug therapy
Shock, Septic / complications*,  diagnosis,  drug therapy
Treatment Outcome
United States / epidemiology
Chemical
Reg. No./Substance:
635-65-4/Bilirubin; 83-43-2/Methylprednisolone
Comments/Corrections
Comment In:
Crit Care Med. 1992 Oct;20(10):1373-4   [PMID:  1395655 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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