Journal Article

Severe Hypothermia Increases the Risk for Intensive Care Unit–Acquired Infection

Kevin B. Laupland, Jean-Ralph Zahar, Christophe Adrie, Clémence Minet, Aurélien Vésin, Dany Goldgran-Toledano, Elie Azoulay, Maité Garrouste-Orgeas, Yves Cohen, Carole Schwebel, Samir Jamali, Michael Darmon, Anne-Sylvie Dumenil, Hatem Kallel, Bertrand Souweine and Jean-François Timsit

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 54, issue 8, pages 1064-1070
Published in print April 2012 | ISSN: 1058-4838
Published online January 2012 | e-ISSN: 1537-6591 | DOI:
Severe Hypothermia Increases the Risk for Intensive Care Unit–Acquired Infection

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Background. Although hypothermia is widely accepted as a risk factor for subsequent infection in surgical patients, it has not been well defined in medical patients. We sought to assess the risk of acquiring intensive care unit (ICU)--acquired infection after hypothermia among medical ICU patients.

Methods. Adults (≥18 years) admitted to French ICUs for at least 2 days between April 2000 and November 2010 were included. Surgical patients were excluded. Patient were classified as having had mild hypothermia (35.0°C–35.9°C), moderate hypothermia (32°C–34.9°C), or severe hypothermia (<32°C), and were followed for the development of pneumonia or bloodstream infection until ICU discharge.

Results. A total of 6237 patients were included. Within the first day of admission, 648 (10%) patients had mild hypothermia, 288 (5%) patients had moderate hypothermia, and 45 (1%) patients had severe hypothermia. Among the 5256 patients who did not have any hypothermia at day 1, subsequent hypothermia developed in 868 (17%), of which 673 (13%), 176 (3%), and 19 (<1%) patients had lowest temperatures of 35.0°C–35.9°C, 32.0°C–34.9°C, and <32°C, respectively. During the course of ICU admission, 320 (5%) patients developed ICU-acquired bloodstream infection and 724 (12%) patients developed ICU-acquired pneumonia. After controlling for confounding variables in multivariable analyses, severe hypothermia was found to increase the risk for subsequent ICU-acquired infection, particularly in patients who did not present with severe sepsis or septic shock.

Conclusions. The presence of severe hypothermia is a risk factor for development of ICU-acquired infection in medical patients.

Journal Article.  3712 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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