What is the role of temperature control in the treatment of sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Fever generally requires no treatment, except in patients who have limited cardiovascular reserve as a consequence of increased metabolic requirements. Antipyretic drugs and physical cooling methods, such as sponging or cooling blankets, may be used to lower the patient’s temperature.

External cooling is another method of fever control that has been reported to be safe and to decrease vasopressor requirements and early mortality in patients with septic shock. In a multicenter, randomized, controlled study comprising febrile patients with septic shock who required vasopressors, mechanical ventilation, and sedation, the group that received external cooling, as compared with the group that did not, exhibited the following [86] :

  • Significantly lower body temperature after 2 hours

  • Significantly more common occurrences of shock reversal in the ICU

  • Significantly lower day-14 mortality

Although a 50% decrease in the vasopressor dose was significantly more common after 12 hours of external cooling treatment, the same result was not found after 48 hours of this therapy. [86]


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