Abstract
Background
Interpretation of human body temperature in patients on continuous renal replacement
therapy (CRRT) is challenging. Clinicians currently use definitions of ‘normal’ temperature
derived from healthy patients over a century ago and apply these definitions to patients
on continuous renal replacement therapy (CRRT). There is a significant opportunity
to refine temperature definitions to apply to the increasing population of critically
ill patients on CRRT.
Methods
A total of 1361 critically ill patients admitted to the hospital between 12/1/2006
and 11/31/2015 and requiring CRRT were studied. Temperature data were summarized (median,
IQR) and compared during time periods that patients were on CRRT and time periods
that they were not on CRRT using paired comparisons. Additionally, analyses were performed
to compare temperature dynamics between patients who died during their hospitalization
with those who did not.
Results
The median body temperature change was −0.6 °C (95% CI −1.3, −0.6) from 12 h before
CRRT to 12 h after CRRT (p < .001), and an increase of 0.6 °C (95% CI 0.2, 0.6) from 12 h before CRRT end to
12 h after CRRT end (p < .001). Temperature significantly increased by a median 0.3 °C from the start to
the end of CRRT.
Conclusions
There are significant body temperature changes in critically ill patients on CRRT
with cooling at the time of CRRT initiation and warming at the time of CRRT cessation.
Key Indexing Terms
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of the Medical SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Body temperature alterations in the critically ill.Intens Care Med. 2004; 30 (PMID -15127194): 811-816https://doi.org/10.1007/s00134-004-2166-z
- Occurrence and outcome of fever in critically ill adults.Critical Care Medicine. 2008; 36 (PMID -18434882): 1531-1535https://doi.org/10.1097/ccm.0b013e318170efd3
- The effects of abnormal body temperature on the prognosis of patients with septic shock.Ther Hypothermia Temp Manag. 2020; 10: 148-152https://doi.org/10.1089/ther.2019.0012
CA. Wunderlich On the Temperature in Diseases: A Manual of Medical Thermometry. The New Sydenham Society 1871 (http://scholar.google.com/scholar?q=On the Temperature in Diseases: A Manual of Medical Thermometry&btnG=&hl=en&num=20&as_sdt=0%2C22).
- Admission Body Temperature in Critically Ill Patients as an Independent Risk Predictor for Overall Outcome.Medical Principles and Practice. 2020; 29: 389-395https://doi.org/10.1159/000505126
- Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American college of critical care medicine and the infectious diseases society of America.Crit Care Med. 2008; 36: 1330-1349https://doi.org/10.1097/CCM.0b013e318169eda9
- Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial.Lancet. 2006; 368 (PMID -16876666): 379-385https://doi.org/10.1016/s0140-6736(06)69111-3
- Preventing hypothermia during continuous veno-venous haemodiafiltration: a randomized controlled trial.J Adv Nurs. 2004; 47: 393-400https://doi.org/10.1111/j.1365-2648.2004.03117.x
- Continuous renal replacement therapy to reduce inflammation in a piglet hemorrhage–reperfusion extracorporeal membrane oxygenation model.Pediatr Res. 2012; 72 (PMID -22669297): 249-255https://doi.org/10.1038/pr.2012.69
- Removal of inflammatory cytokines and endotoxin by veno-venous continuous renal replacement therapy for burned patients with sepsis.Burns. 2005; 31 (PMID -15975721): 623-628https://doi.org/10.1016/j.burns.2005.02.004
- The acute dialysis quality initiative—part IV: membranes for CRRT.Adv Renal Replace Ther. 2002; 9 (PMID -12382229): 265-267https://doi.org/10.1053/jarr.2002.35568
- Cooling effect of continuous renal replacement therapy in critically ill patients.Am J Kidney Dis. 1998; 32: 1023-1030https://doi.org/10.1016/s0272-6386(98)70078-2
- A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich.JAMA. 1992; 268: 1578-1580
- Management of fever in neutropenic patients with different risks of complications.Clin Infect Dis. 2004; 39 (PMID -15250018): S32-S37https://doi.org/10.1086/383050
Article info
Publication history
Published online: April 20, 2022
Accepted:
March 22,
2022
Received:
June 5,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
