Temperature profiles in adult intensive care unit patients treated for infection in a tertiary intensive care unit: A single-centre prospective observational cohort study.

Objective: The objective of this study was to evaluate temperature profiles in patients treated for infections in the intensive care unit (ICU) to establish the number of patients who might be eligible for a clinical trial of therapeutic warming. Design setting and participants: A prospective observational study was conducted in a Wellington ICU over a 3-month period in 2024 including consecutive adult unplanned admissions and excluding those with brain injury or seizures. Main outcome measures: We screened 200 eligible patients. Our primary outcome was the proportion of all unplanned ICU admission episodes where patients were treated for infection within 14 days in the ICU. Patients treated for an infection were divided into four groups (≥38.3 °C, ≥37.5-38.2 °C, 36-37.4 °C, and <36 °C) using their most recent temperature prior to the first antimicrobial in the ICU (or at admission for patients already on antimicrobials). A key physiological/process measure was the fever deficit, defined as the number of degree-hours <38.3 °C within 24, 48, and 72 h. Results: A total of 43.3% of unplanned ICU admissions resulted in treatment of infection within 14 days. A total of nine of 123 patients had a body temperature ≥38.3 °C (7.3%) when first treated for infection in the ICU, while 94 of 123 patients (76.4%) had a body temperature <37.5 °C. Fever deficits over 24-, 48-, and 72-h periods increased by decreasing body temperature group with a high proportion of hours spent with a body temperature <38.3 °C in all groups. Conclusion: A large number of patients treated for infection in the ICU may be able to be included in a trial evaluating induced hyperthermia.