Heart & lung : the journal of critical care · 2026
Clinical significance of elevated body temperature without infection following removal of VA-ECMO.
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Nakayama Tomoaki, Kataoka Yu, Makimura Yuma, Hirashima Kodai, Miyagawa Sachie, Mitsui Kentaro, Murai Kota, Iwai Takamasa, Sawada Kenichiro, Matama Hideo, Honda Satoshi, Takagi Kensuke, Fujino Masashi, Yoneda Shuichi, Otsuka Fumiyuki, Nakao Kazuhiro, Asaumi Yasuhide, Kutsuzawa Rieko, Suzuki Kota, Kakuta Takashi, Yamashita Kizuku, Kawamoto Naonori, Fukushima Satsuki, Satomi Kazuhiro, Noguchi Teruo
Аннотация
BACKGROUND: Previous studies have reported elevated body temperature following the removal of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, the clinical implications of elevated body temperature after the removal of VA-ECMO remain unknown.
OBJECTIVES: To characterize elevated body temperature after VA-ECMO removal in patients with cardiogenic shock (CS).
METHODS: We retrospectively evaluated 163 CS patients undergoing VA-ECMO removal. All patients did not exhibit any evidence of infection. Blood temperature was continuously monitored using a Swan-Ganz catheter. Elevated body temperature was defined as a maximum body temperature ≥38.0 °C within 24 h after VA-ECMO removal. All-cause mortality was compared between patients with and without elevated body temperature.
RESULTS: Elevated body temperature was observed in 58.9% (96/163) of study subjects. Patients with elevated body temperature had higher C-reactive protein (CRP) levels (11.1 ± 8.6 vs. 8.5 ± 6.1 mg/dL, p = 0.027), accompanied by reductions in systolic blood pressure and systemic vascular resistance, and increased lactate levels. CRP levels independently predicted elevated body temperature (OR=1.050, 95%CI=1.003-1.100, p = 0.037). All-cause mortality did not differ between the two groups (30.2%vs. 29.9%, log-rank p = 0.983). However, among patients with elevated body temperature, an increase in body temperature, especially ≥1.1 °C, was associated with higher all-cause mortality (HR=1.968, 95%CI=1.096-3.535, p = 0.023).
CONCLUSIONS: In CS patients requiring VA-ECMO, body temperature elevated in 58.9% patients after the removal of VA-ECMO. In those with elevated body temperature, a greater rise in body temperature was associated with higher mortality, suggesting body temperature as a potential signature to stratify risks of mortality in CS patients without any infectious signs.
OBJECTIVES: To characterize elevated body temperature after VA-ECMO removal in patients with cardiogenic shock (CS).
METHODS: We retrospectively evaluated 163 CS patients undergoing VA-ECMO removal. All patients did not exhibit any evidence of infection. Blood temperature was continuously monitored using a Swan-Ganz catheter. Elevated body temperature was defined as a maximum body temperature ≥38.0 °C within 24 h after VA-ECMO removal. All-cause mortality was compared between patients with and without elevated body temperature.
RESULTS: Elevated body temperature was observed in 58.9% (96/163) of study subjects. Patients with elevated body temperature had higher C-reactive protein (CRP) levels (11.1 ± 8.6 vs. 8.5 ± 6.1 mg/dL, p = 0.027), accompanied by reductions in systolic blood pressure and systemic vascular resistance, and increased lactate levels. CRP levels independently predicted elevated body temperature (OR=1.050, 95%CI=1.003-1.100, p = 0.037). All-cause mortality did not differ between the two groups (30.2%vs. 29.9%, log-rank p = 0.983). However, among patients with elevated body temperature, an increase in body temperature, especially ≥1.1 °C, was associated with higher all-cause mortality (HR=1.968, 95%CI=1.096-3.535, p = 0.023).
CONCLUSIONS: In CS patients requiring VA-ECMO, body temperature elevated in 58.9% patients after the removal of VA-ECMO. In those with elevated body temperature, a greater rise in body temperature was associated with higher mortality, suggesting body temperature as a potential signature to stratify risks of mortality in CS patients without any infectious signs.