Body temperature variation following packed cell transfusion in adult patients with sepsis - Where will the pendulum stop?

BACKGROUND: Critically ill patients with sepsis often require packed cell transfusions (PCT). PCT causes changes in body's core temperature.

OBJECTIVE: To trace the course and amplitude of body core temperature following PCT in adults with sepsis.

METHODS: We conducted a population-based retrospective cohort study of patients with sepsis who received one unit of PCT during their hospitalization in a general intensive care unit during 2000-2019. A control group was established by matching each of these patients to a patient who did not receive PCT. We calculated the mean values of urinary bladder temperature for the 24 hours before, and 24 hours after PCT. To evaluate the effect of PCT on body core temperature, multivariable analyses using a mixed linear regression model were performed.

RESULTS: The study comprised 1100 patients who received one unit of PCT, and 1100 matched patients. The mean temperature before PCT was 37.3 °C. Immediately from initiation of PCT, body temperature decreased, to a minimum of 37.0 °C. During the 24 subsequent hours, the temperature increased gradually and consistently, until a peak temperature of 37.4 °C. In a linear regression model, body core temperature increased by a mean 0.06 °C in the first 24 hours following PCT, and decreased by a mean 0.65 °C for every 1.0 °C increase before PCT.

CONCLUSIONS: Among critically ill patients with sepsis, PCT itself causes only mild and clinically insignificant temperature changes. Thus, significant changes in core temperature during the 24 hours following PCT may indicate an unusual clinical event that requires clinicians' immediate attention.