Effect of active temperature management on mortality in intensive care unit patients.

摘要: OBJECTIVE To evaluate the effect of active temperature management on mortality, intensive care unit (ICU) and hospital length stay, as well relative efficacy antipyretic medications physical cooling devices for achieving reductions in critically ill adults. DESIGN, SETTING AND PARTICIPANTS Systematic review meta-analysis randomised controlled trials (RCTs) investigating treatments administered to febrile patients order reduce body temperature. Fifteen studies reporting results from 13 RCTs met our eligibility criteria. INTERVENTIONS Treatments were defined cooling, nonsteroidal anti-inflammatory drugs, paracetamol, or any combination these. MAIN OUTCOME MEASURES The primary outcome variable was all-cause mortality at longest time point after randomisation. Secondary outcomes ICU 12 hours RESULTS Active control had no statistically significant association with (odds ratio, 1.01; 95% confidence interval [CI], 0.81-1.28; P = 0.95, fixed effects). There between stay. associated a reduction effects estimate minus treatment pharmaceutical -0.62C (95% CI, -0.72C -0.51C; < 0.001) -1.59C -1.82C -1.35C; 0.001). CONCLUSIONS neither increased nor decreased risk When therapeutic goal is temperature, approaches may be more effective than pharmacological measures