Clinical significance of elevated body temperature without infection following removal of VA-ECMO
Year: 2026
Type: article
Abstract: Background Previous studies have reported elevated body temperature following the removal of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, the clinical implications of elevated body temperature after the removal of VA-ECMO remain unknown. Objectives To characterize elevated body temperature after VA-ECMO removal in patients with cardiogenic shock (CS). Methods We retrospectively evaluated 163 CS patients undergoing VA-ECMO removal. All patients did not exhibit any evidence of infection. Blood temperature was continuously monitored using a Swan–Ganz catheter. Elevated body temperature was defined as a maximum body temperature ≥38.0 °C within 24 h after VA-ECMO removal. All-cause mortality was compared between patients with and without elevated body temperature. Results Elevated body temperature was observed in 58.9% (96/163) of study subjects. Patients with elevated body temperature had higher C-reactive protein (CRP) levels (11.1 ± 8.6 vs. 8.5 ± 6.1 mg/dL, p = 0.027), accompanied by reductions in systolic blood pressure and systemic vascular resistance, and increased lactate levels. CRP levels independently predicted elevated body temperature (OR=1.050, 95%CI=1.003–1.100, p = 0.037). All-cause mortality did not differ between the two groups (30.2%vs. 29.9%, log-rank p = 0.983). However, among patients with elevated body temperature, an increase in body temperature, especially ≥1.1 °C, was associated with higher all-cause mortality (HR=1.968, 95%CI=1.096–3.535, p = 0.023). Conclusions In CS patients requiring VA-ECMO, body temperature elevated in 58.9% patients after the removal of VA-ECMO. In those with elevated body temperature, a greater rise in body temperature was associated with higher mortality, suggesting body temperature as a potential signature to stratify risks of mortality in CS patients without any infectious signs.
Source: Heart & Lung
Authors: Tomoaki Nakayama, Yu Kataoka, Yuma Makimura, Kodai Hirashima, Sachie Miyagawa, Kentaro Mitsui, Kota Murai, Takamasa Iwai, Kenichiro Sawada, Hideo Matama, Satoshi Honda, Kensuke Takagi, Masashi Fujino, Shuichi Yoneda, Fumiyuki Otsuka, Kazuhiro Nakao, Yasuhide Asaumi, Rieko Kutsuzawa, Kota Suzuki, Takashi Kakuta, Kizuku Yamashita, Naonori Kawamoto, Satsuki Fukushima, Kazuhiro Satomi, Teruo Noguchi
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: hybrid
Estimated APC paid: $3,600
OpenAlex ID: W7222799557