• J Villar and A S Slutsky.
• Intensive Care Unit, Hospital del Pino, Las Palmas, Canary Islands, Spain.
• Resuscitation. 1993 Oct 1; 26 (2): 183-92.

ObjectiveTo test the hypothesis that treatment with hypothermia affects the course of overwhelming acute respiratory failure associated with sepsis.DesignConcurrent-controlled, prospective study.SettingAdult multidisciplinary ICU in a teaching hospital.PatientsNineteen consecutive patients with septic ARDS mechanically ventilated and a P(A-a)O2 > 500 Torr during 36 h on > or = 10 cm H2O of PEEP.InterventionsPatients were assigned to receive conventional treatment (n = 10) or conventional treatment plus mild hypothermia (32-35 degrees C) instituted as a last resort (n = 9).ResultsHypothermia (33.7 +/- 0.6 degrees C) was associated with a reduction in mortality rate (67% vs. 100%, P < 0.05), P(A-a)O2 (P < 0.001), heart rate (P < 0.001), cardiac index (P < 0.01), and QS/QT (P < 0.01). There were no significant differences in oxygen consumption (VO2) before (243 +/- 74 ml/min) and during treatment with hypothermia (246 +/- 87 ml/min) although O2 extraction increased during hypothermia (26 +/- 6 vs. 30 +/- 6%, P < 0.05).ConclusionsThis study suggests that hypothermia was effective in improving oxygenation and survival in patients with severe ARDS associated with sepsis, even though VO2 was unchanged.

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