Objectives: To investigate the effects of target temperature management on hemodynamic changes, inflammatory and immune factors, and clinical outcomes of sepsis patients with fever.
Methods: Patients diagnosed with sepsis with a core temperature of ≥39°C were randomly divided into two groups: a low-temperature group (LT group: 36.5°C-38°C) and a high-temperature group (HT group: 38.5°C-39.5°C). A target core temperature was achieved within 6 hrs posttreatment and maintained for 24 hrs. Then, the hemodynamic changes, inflammatory and immune factors, and clinical outcomes were evaluated.
Results: Compared with the HT group, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) showed a significant decrease in the LT group (P < 0.05). In contrast, IL-4 and IL-10 were higher in the LT group than in the HT group (P < 0.05). The CD4-T lymphocyte (CD4+), CD8-T lymphocyte (CD8+), and monocytic human leukocyte antigen-DR (mHLA-DR) in the LT group were higher than in the HT group (P < 0.05). The ICU stay and the anti-infection treatment costs were higher in the LT group (P < 0.05).
Conclusion: Low-temperature management of patients resulted in a low level of proinflammatory cytokines. Excessive temperature control in sepsis patients with fever may be harmful.