To specify whether an association exists between pre-hospital body temperature collected by the emergency medical services (EMS) call centre, and intensive care unit (ICU) admission of patients with septic shock. An observational study based on data collected by the EMS of Paris. All septic shocks were included. Among, the 140 calls concerning septic shock, 22 patients (16%) were admitted to ICU. The mean core temperature was 37.4±1.6°C for ICU and 38.6±1.1°C (p<4.10^-5) for non-ICU patients. Using propensity score analysis, the relative risk for ICU admission of patients with pre-hospital fever or hypothermia was 0.31 and 2 respectively. The study highlights the potential usefulness of early temperature measurement in septic shock patients to allow early proper orientation.

[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]

References

1. Brun-Buisson C. The epidemiology of the systemic inflammatory response. Intensive Care Med. 2000;26 Suppl 1:S64-74.
2. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 23 févr 2016;315(8):801-10.
3. Ferrer R, Artigas A, Levy MM, Blanco J, González-Díaz G, Garnacho-Montero J, et al. Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. JAMA. 21 mai 2008;299(19):2294-303.
4. Nguyen HB, Van Ginkel C, Batech M, Banta J, Corbett SW. Comparison of Predisposition, Insult/Infection, Response, and Organ dysfunction, Acute Physiology And Chronic Health Evaluation II, and Mortality in Emergency Department Sepsis in patients meeting criteria for early goal-directed therapy and the severe sepsis resuscitation bundle. J Crit Care. août 2012;27(4):362-9.
5. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 8 nov 2001;345(19):1368-77.
6. Adnet F, Lapostolle F. International EMS systems: France. Resuscitation. oct 2004;63(1):7-9.
7. Télion C, Greffet A, Rozenberg A, Lejay M, Jannière D, Carli P. [Is the direct admission to the recovery service or to the intensive care unit of patients cared for by the Smur system justified?]. Ann Fr Anesth Reanim. nov 2000;19(9):654-61.
8. Pottecher T, Calvat S, Dupont H, Durand-Gasselin J, Gerbeaux P, SFAR/SRLF workgroup. Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France. Crit Care Lond Engl. 2006;10(4):311.
9. Jones M. NEWSDIG: the national early warning score development and implementation group. Clin. Med. 2012;12(6):501–503.
10. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 23 févr 2016;315(8):762-74.
11. Jouffroy R, Saade A, Carpentier A, Ellouze S, Philippe P, Idialisoa R, et al. Triage of Septic Patients Using qSOFA Criteria at the SAMU Regulation: A Retrospective Analysis. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 9 août 2017;1-7.
12. Circiumaru B, Baldock G, Cohen J. A prospective study of fever in the intensive care unit. Intensive Care Med. juill 1999;25(7):668-73.
13. O’Grady NP, Barie PS, Bartlett JG, Bleck T, Carroll K, Kalil AC, et al. Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America. Crit Care Med. avr 2008;36(4):1330-49.
14. Thong WY, Strickler AG, Li S, Stewart EE, Collier CL, Vaughn WK, et al. Hyperthermia in the forty-eight hours after cardiopulmonary bypass. Anesth Analg. déc 2002;95(6):1489-1495, table of contents.
15. Bellomo R, Bersten AD, Boots RJ, Bristow PJ, Dobb GJ, Finfer SR, et al. The use of antimicrobials in ten Australian and New Zealand intensive care units. The Australian and New Zealand Intensive Care Multicentre Studies Group Investigators. Anaesth Intensive Care. déc 1998;26(6):648-53.
16. Rumbus Z, Matics R, Hegyi P, Zsiboras C, Szabo I, Illes A, et al. Fever Is Associated with Reduced, Hypothermia with Increased Mortality in Septic Patients: A Meta-Analysis of Clinical Trials. PloS One. 2017;12(1):e0170152.