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Spontaneous hypothermia in human sepsis is a transient, self-limiting, and nonterminal response.

Authors :
Fonseca MT
Rodrigues AC
Cezar LC
Fujita A
Soriano FG
Steiner AA
Source :
Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2016 Jun 15; Vol. 120 (12), pp. 1394-401. Date of Electronic Publication: 2016 Mar 17.
Publication Year :
2016

Abstract

Hypothermia in sepsis is generally perceived as something dysregulated and progressive although there has been no assessment on the natural course of this phenomenon in humans. This was the first study on the dynamics of hypothermia in septic patients not subjected to active rewarming, and the results were surprising. A sample of 50 subjects presenting with spontaneous hypothermia during sepsis was drawn from the 2005-2012 database of an academic hospital. Hypothermia was defined as body temperature below 36.0°C for longer than 2 h, with at least one reading of 35.5°C or less. The patients presented with 138 episodes of hypothermia, 21 at the time of the sepsis diagnosis and 117 with a later onset. However, hypothermia was uncommon in the final 12 h of life of the patients that succumbed. The majority (97.1%) of the hypothermic episodes were transient and self-limited; the median recovery time was 6 h; body temperature rarely fell below 34.0°C. Bidirectional oscillations in body temperature were evident in the course of hypothermia. Nearly half of the hypothermic episodes had onset in the absence of shock or respiratory distress, and the incidence of hypothermia was not increased during either of these conditions. Usage of antipyretic drugs, sedatives, neuroleptics, or other medications did not predict the onset of hypothermia. In conclusion, hypothermia appears to be a predominantly transient, self-limiting, and nonterminal phenomenon that is inherent to human sepsis. These characteristics resemble those of the regulated hypothermia shown to replace fever in animal models of severe systemic inflammation.<br /> (Copyright © 2016 the American Physiological Society.)

Details

Language :
English
ISSN :
1522-1601
Volume :
120
Issue :
12
Database :
MEDLINE
Journal :
Journal of applied physiology (Bethesda, Md. : 1985)
Publication Type :
Academic Journal
Accession number :
26989218
Full Text :
https://doi.org/10.1152/japplphysiol.00004.2016