Adding to the discussion on therapeutic hypothermia or just avoiding hyperthermia in cardiac arrest patients after ROSC, there’s a new systematic review slash meta-analysis on infection rates in hypothermic vs normothermic patients. Prolonged therapeutic hypothermia shows an increased risk of pneumonia and sepsis.
There have been systematic reviews on this subject earlier, swinging from no difference, to a slight increase in infections in therapeutic hypothermia. This new meta-analysis finds added harm caused by pneumonia and sepsis, and a tendency for increased risk of all infections in the hypothermic patient. Logically, the risk increased when the patient was kept hypothermic over longer periods – increasing over 12 and 24 hours. Also expected, no tendency for increased infections were found for short durations of hypothermia – as during some intracerebral procedures.
The confidence interval of the added risk barely makes it across statistical significance, but if therapeutic hypothermia adds risk for infection, and doesn’t bring extra benefits with it, that’s an extra argument for leaving 33 degrees and going for aggressive normothermia.