Fever following extracorporeal membrane oxygenation decannulation: Infection, thrombosis or just physiology? - Institut de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition
Article Dans Une Revue Journal of Critical Care Année : 2025

Fever following extracorporeal membrane oxygenation decannulation: Infection, thrombosis or just physiology?

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Purpose: Fever is frequent after extracorporeal membrane oxygenation (ECMO) decannulation. We aimed to evaluate the incidence of post-decannulation fever and describe its causes. Methods: Adult ECMO patients who were successfully weaned from ECMO were retrospectively included. Minimal and maximal core temperatures were collected daily for each patient from 48 h before decannulation up to 5 days after. Patients were grouped according to the cause of fever (infection, thrombosis, or no evident cause) and compared. Plasma cytokine profile was obtained, each day from decannulation to 5 days after for 20 patients. Results: Between January 2021 and December 2022, 123 patients successfully weaned from ECMO were included. Post-decannulation fever occurred in 54 patients (44 %). It was associated with an infection in 39 patients (72 %) and with a thrombosis in 6 patients (11 %), and no cause was identified in the remaining 9 (17 %). Prolonged ECMO duration, extended ICU length-of-stay, diabetes and vascular comorbidities were significantly associated with a higher risk of infection. Finally, the pro-inflammatory cytokine profiles did not differ between febrile and afebrile patients. Conclusion: Post-decannulation fever was common, and was mainly due to infections or thrombosis. Fever should therefore not be considered as a benign inflammatory reaction until proven otherwise.
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hal-04831889 , version 1 (11-12-2024)

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Benjamin Assouline, Gianlucca Belli, Karim Dorgham, Quentin Moyon, Alexandre Coppens, et al.. Fever following extracorporeal membrane oxygenation decannulation: Infection, thrombosis or just physiology?. Journal of Critical Care, 2025, 85, pp.154945. ⟨10.1016/j.jcrc.2024.154945⟩. ⟨hal-04831889⟩
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