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BJA Advance Access published online on October 14, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh291
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted August 19, 2004

Clinical Investigation

Effect of excessive environmental heat on core temperature in critically ill patients. An observational study during the 2003 European heat wave

F. Stéphan 1*, S. Ghiglione 1, F. Decailliot 1, L. Yakhou 1, P. Duvaldestin 1, and P. Legrand 2

1 Réanimation chirurgicale et traumatologique, Service d'Anesthésie-Réanimation, AP-HP Hôpital Henri Mondor and Université Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France
2 Laboratoire de Bactériologie, AP-HP Hôpital Henri Mondor and Université Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France

* To whom correspondence should be addressed. E-mail: francois.stephan{at}hmn.ap-hop-paris.fr.


  Abstract

Background. The primary goal of this study was to investigate the relation between the core temperature of critically ill patients and hot ambient temperatures during a heat wave. The second goal was to evaluate the impact of such a heat wave on the number of microbiological tests ordered.

Methods. During a heat wave, from August 3 to 22, 2003, we conducted an observational study in the surgical intensive care unit (ICU) of a French hospital that had no air-conditioning at the time. The core temperature of 18 critically ill patients and 36 health-care workers was measured with a non-contact, infrared tympanic membrane thermometer. The association between the core body temperature in infected and non-infected critically ill patients and the staff members, and the ambient temperature in the ICU was analysed using linear regression. The number of microbiological tests ordered was also recorded and compared with the same period in the previous year.

Results. The equation of the regression line for infected critically ill patients was: core temperature=33.5+0.16xambient temperature (R2=0.53; P<0.0001). The regression line was steeper than that for the non-infected patients (0.077; P<0.0001). The slopes of the regression lines for non-infected and control patients were similar (P=0.20). More blood cultures were carried out during the heat wave than at the same period during the year 2002 (4.80 blood cultures per 1000 patient-days vs 2.47 per 1000 patient-days; P=0.0006).

Conclusion. During a sustained high ambient temperature, hyperthermia can occur in critically ill infected patients and to a lesser extent in non-infected patients and health-care workers. The number of blood cultures requested rises substantially, leading to increased costs. Installation of air-conditioning is therefore recommended.

Keywords: blood, cultures; complications, heat wave; complications, hyperthermia; complications, critically ill patients; monitoring, core temperature.
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