Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi 2-1, Aoba-ku, Sendai, Miyagi, 980-8574 Japan ; Department of Emergency and Critical Care Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574 Japan.
Department of Emergency and Critical Care Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574 Japan.
J Intensive Care. 2014 Feb 18;2(1):14. doi: 10.1186/2052-0492-2-14. eCollection 2014.
Body temperature abnormalities, which occur because of several infectious and non-infectious etiologies, are among the most commonly noted symptoms of critically ill patients. These abnormalities frequently trigger changes in patient management. The purpose of this article was to review the contemporary literature investigating the definition and occurrence of body temperature abnormalities in addition to their impact on illness severity and mortality in critically ill non-neurological patients, particularly in patients with severe sepsis. Reports on the influence of fever on outcomes are inconclusive, and the presence of fever per se may not contribute to increased mortality in critically ill patients. In patients with severe sepsis, the impacts of elevated body temperature and hypothermia on mortality and the severity of physiologic decline are different. Hypothermia is significantly associated with an increased risk of mortality. In contrast, elevated body temperature may not be associated with increased disease severity or risk of mortality. In patients with severe sepsis, the effect of fever and fever control on outcomes requires further research.
体温异常是重症患者最常见的症状之一，其发生原因包括多种感染性和非感染性病因。这些异常常导致患者管理的改变。本文旨在回顾有关重症非神经科患者（尤其是严重脓毒症患者）体温异常的定义和发生情况及其对疾病严重程度和死亡率影响的当代文献，特别关注发热对结局的影响。发热对结局的影响尚无定论，发热本身的存在可能不会增加重症患者的死亡率。在严重脓毒症患者中，体温升高和低体温对死亡率和生理恶化严重程度的影响不同。低体温与死亡率增加显著相关。相比之下，体温升高可能与疾病严重程度或死亡率增加无关。严重脓毒症患者中，发热和发热控制对结局的影响需要进一步研究。
