The Association of Fever with Total Mechanical Ventilation Time in Critically Ill Patients.
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°C 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°C to 37.4°C. In multivariate linear regression analysis, patients with three categories of fever (MAX(MV) of 37.5°C to 38.4°C, 38.5°C to 39.4°C, and ≥ 39.5°C) 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.
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Dong Won
http://orcid.org/0000-0002-4538-6045
DW
Park
Department of Anesthesiology, Kobe University Hospital, Kobe, Japan.
Moritoki
http://orcid.org/0000-0002-0099-3060
M
Egi
Department of Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan.
Masaji
http://orcid.org/0000-0002-8679-2672
M
Nishimura
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Youjin
http://orcid.org/0000-0002-4838-466X
Y
Chang
Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gee Young
http://orcid.org/0000-0001-5473-1712
GY
Suh
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Chae Man
http://orcid.org/0000-0001-5400-6588
CM
Lim
Department of Pulmonary and Critical Care Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Jae Yeol
http://orcid.org/0000-0003-3631-4610
JY
Kim
Department of Anesthesiology and Intensive Care Medicine, Hiroshima City Hospital, Hiroshima, Japan.
Keiichi
http://orcid.org/0000-0003-0736-2322
K
Tada
Division of Intensive Care Unit, New Tokyo Hospital, Tokyo, Japan.
Koichi
http://orcid.org/0000-0002-0447-0742
K
Matsuo
Division of Intensive and Coronary Care Unit, Nippon Medical School Hospital, Tokyo, Japan.
Shinhiro
http://orcid.org/0000-0001-6969-2189
S
Takeda
Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Yamaguchi, Japan.
Ryosuke
http://orcid.org/0000-0002-7397-8507
R
Tsuruta
Intensive Care Unit, Department of Anesthesiology, Teine Keijinkai Hospital, Sapporo, Japan.
Takeshi
T
Yokoyama
Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Seon Ok
http://orcid.org/0000-0001-9010-5460
SO
Kim
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. yskoh@amc.seoul.kr.
Younsuck
http://orcid.org/0000-0001-5066-2027
Y
Koh
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D016638:Critical Illness; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011446:Prospective Studies; D056910:Republic of Korea; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013997:Time Factors
Body Temperature; Fever; Intensive Care Units; Mechanical Ventilation