Prevalence of low-normal body temperatures and use of active warming in emergency department patients presenting with severe infection.

OBJECTIVE: To describe the prevalence of low-normal body temperatures in emergency department (ED) patients presenting with severe infection, and to determine whether active warming is used in this setting.

DESIGN, SETTING AND PARTICIPANTS: We performed a singlecentre retrospective cohort study in ED patients with community-acquired infection who required admission to the intensive care unit (ICU). Temperatures recorded from presentation up until 24 hours in the ICU were extracted from the patients' clinical records. Body temperatures were then classified as low (≤ 36.4°C), normothermic (36.5-37.9°C) or fever ≥ 38°C.

RESULTS: Over the study period, 574 patients were admitted to the ICU with infection. Of them, 151 fulfilled the inclusion criteria, and the in-hospital mortality rate for these patients was 8.6%. On presentation, 22.5% (34 patients) had a low body temperature (35-35.9°C for six patients, and < 35.0°C for three patients). In contrast, 26.5% (40 patients) had a temperature ≥ 38.0°C. Among those who presented with low temperature, the median time to reach normothermia was 7.9 hours (range, 3.3-14.0 hours). Active warming was only applied to one patient, (whose body temperature was < 35°C).

CONCLUSION: Among patients with community-acquired infection requiring ICU admission, about a quarter have a low temperature and active warming was essentially not applied. These findings suggest that active warming of such patients would likely achieve separation from usual care.