Fever Is Associated with Delayed Ventilator Liberation in Acute Lung Injury

Netzer, Giora; Dowdy, David W.; Harrington, Thelma; Chandolu, Satish; Dinglas, Victor D.; Shah, Nirav G.; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Hasday, Jeffrey D.; Needham, Dale M.

doi:10.1513/annalsats.201303-052oc

Cited by 22 publications

(25 citation statements)

References 59 publications

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“…Similar to our present study, Netzer et al (20) conducted a prospective cohort study on mechanically ventilated patients with acute lung injury. These authors demonstrated that an additional febrile day during the first week after acute lung injury was strongly related to delayed weaning from MV, but more than two thirds of the enrolled cases were related to sepsis.…”

Section: Discussionsupporting

confidence: 68%

“…In addition, we demonstrated that the degree of body temperature in mechanically ventilated patients was significantly associated with a prolonged TVT. These are the main features of this study that deserve to be highlighted as they differentiate it from the study by Netzer et al (20). …”

Section: Discussionmentioning

confidence: 59%

“…Recently, in a cohort study of mainly septic patients with acute lung injury, fever was found to be associated with a prolonged duration of MV (20). However, another study on patients with acute respiratory distress syndrome reported contradictory results that fever in early phase may be an important factor in determining favorable outcome (21).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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 (MAXMV). To assess the independent association of MAXMV 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 MAXMV on ventilator-free days was also observed by quantile regression analysis in all subjects including non-survivors. After propensity score matching, a MAXMV ≥ 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 MAXMV of 36.5°C to 37.4°C. In multivariate linear regression analysis, patients with three categories of fever (MAXMV 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 MAXMV in both categories of ICU admission. A significant association between MAXMV 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.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…This study adds to the literature on temperature abnormalities in critically ill patients with ARDS and is 1 of 2 new studies to investigate the association between temperature and mortality in this subgroup of critically ill patients. Netzer et al 25 recently published findings from their secondary analysis of 450 patients from the Improving Care of Acute Lung Injury patients study cohort. The frequency of temperature alterations in their study was higher than in our sample.…”

Section: Discussionmentioning

confidence: 99%

Body Temperature and Mortality in Patients with Acute Respiratory Distress Syndrome

Schell-Chaple

Puntillo

Matthay

et al. 2015

American Journal of Critical Care

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Background Little is known about the relationship between body temperature and outcomes in patients with acute respiratory distress syndrome (ARDS). A better understanding of this relationship may provide evidence for fever suppression or warming interventions, which are commonly applied in practice. Objective To examine the relationship between body temperature and mortality in patients with ARDS. Methods Secondary analysis of body temperature and mortality using data from the ARDS Network Fluid and Catheter Treatment Trial (n =969). Body temperature at baseline and on study day 2, primary cause of ARDS, severity of illness, and 90-day mortality were analyzed by using multiple logistic regression. Results Mean baseline temperature was 37.5°C (SD, 1.1°C; range, 27.2°C-40.7°C). At baseline, fever (≥ 38.3°C) was present in 23% and hypothermia (< 36°C) in 5% of the patients. Body temperature was a significant predictor of 90-day mortality after primary cause of ARDS and score on the Acute Physiology and Chronic Health Evaluation III were adjusted for. Higher temperature was associated with decreased mortality: for every 1°C increase in baseline temperature, the odds of death decreased by 15% (odds ratio, 0.85; 95% CI, 0.73-0.98, P = .03). When patients were divided into 5 temperature groups, mortality was lower with higher temperature (P for trend=.02). Conclusions Early in ARDS, fever is associated with improved survival rates. Fever in the acute phase response to lung injury and its relationship to recovery may be an important factor in determining patients' outcome and warrants further study.

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“…Transport limitations coupled with increased interstitial fluid pressure (IFP) within solid tumors [14] disrupt tissue homeostasis and generate hypoxic and necrotic tissue [15], and are also obstacles for systemically administered nanoparticles and chemotherapeutics. While circulating nanoparticles can preferentially exit fenestrated tumor capillaries [16] via the so-called enhanced permeability and retention effect (EPR), their diffusion is hindered beyond 3-5 cell diameters from point of extravasation [17,18].…”

mentioning

confidence: 99%

An Interdisciplinary Computational/Experimental Approach to Evaluate Drug-Loaded Gold Nanoparticle Tumor Cytotoxicity

Curtis

England

et al. 2016

Nanomedicine (Lond.)

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Aim: Clinical translation of cancer nanotherapy has largely failed due to the infeasibility of optimizing the complex interaction of nano/drug/tumor/patient parameters. We develop an interdisciplinary approach modeling diffusive transport of drug-loaded gold nanoparticles in heterogeneously-vascularized tumors. Materials & methods: Evaluated lung cancer cytotoxicity to paclitaxel/cisplatin using novel two-layer (hexadecanethiol/phosphatidylcholine) and three-layer (with high-densitylipoprotein) nanoparticles. Computer simulations calibrated to in-vitro data simulated nanotherapy of heterogeneously-vascularized tumors. Results: Evaluation of freedrug cytotoxicity between monolayer/spheroid cultures demonstrates a substantial differential, with increased resistance conferred by diffusive transport. Nanoparticles had significantly higher efficacy than free-drug. Simulations of nanotherapy demonstrate 9.5% (cisplatin) and 41.3% (paclitaxel) tumor radius decrease. Conclusion: Interdisciplinary approach evaluating gold nanoparticle cytotoxicity and diffusive transport may provide insight into cancer nanotherapy.

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Fever Is Associated with Delayed Ventilator Liberation in Acute Lung Injury

Cited by 22 publications

References 59 publications

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

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

Body Temperature and Mortality in Patients with Acute Respiratory Distress Syndrome

An Interdisciplinary Computational/Experimental Approach to Evaluate Drug-Loaded Gold Nanoparticle Tumor Cytotoxicity

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