PubMed · 11426090
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J E Cottrell, J Hartung. 2001. A case in point.. https://doi.org/10.1097/00008506-200107000-00001
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Although much progress has been made in elucidating the mechanisms underlying the physiological regulation of fever, there is little understanding of the biological utility of fever's thermal component. Considering the evolutionary co-conservation of fever and innate immunity, we hypothesize that fever's thermal component might in general augment innate immune function and, in particular, neutrophil activation. Accordingly, we have evaluated the effect of febrile temperatures on neutrophil function at the single-cell level. We find that reactive oxygen intermediates and NO release are greatly enhanced at febrile temperatures for unstimulated as well as LPS-stimulated adherent human neutrophils. Furthermore, our studies suggest that these changes in oxidant release are linked to upstream changes in NADPH dynamics. Inasmuch as reactive oxygen intermediates and NO production are important elements in innate immune responses to bacterial pathogens, we suggest that the febrile rise in core temperature is a broad-based systemic signaling mechanism to enhance innate immunity.
Postoperative wound infection is a common and serious complication of surgery. This review will focus on 2 factors known to modulate perioperative immunity: maintenance of perioperative normothermia and provision of supplemental perioperative oxygen. Hypothermia causes numerous adverse outcomes, including morbid myocardial events, increased blood loss and transfusion requirement, postsurgical wound infections, and prolonged hospitalization. Perioperative normothermia should thus be maintained unless therapeutic hypothermia is specifically indicated. Supplemental perioperative oxygen (inspired fraction of 80% instead of 30%) significantly reduces postoperative nausea and vomiting, diminishes the decrease in phagocytosis and bacterial killing usually associated with anesthesia and surgery, and reduces the rate of postoperative wound infection among patients who undergo colon resection. Available data thus suggest that supplemental perioperative oxygen improves surgical outcome with little or no associated risk.
BACKGROUND: Infrared ear thermometry is frequently used in children, because this is a quick method of taking temperature and the ear is easily accessible. Our aim was to evaluate agreement between temperature measured at the rectum and ear in children. METHODS: We did a systematic review of studies comparing temperature measured at the rectum (the reference site) using mercury, electronic, or indwelling probe thermometers, with temperature measured at the ear (the test site) using infrared ear thermometers. Heterogeneity between studies was investigated by exploring subgroups according to the mode of the infrared ear thermometer. FINDINGS: 44 studies containing 58 comparisons (5935 children) were eligible for inclusion in this review. Outcome data were available in reports from 12 comparisons (2312 [39%] children), and data on individual patients were obtained for a further 19 comparisons (2129 [36%] children). 31 comparisons (4441 [75%] children) were therefore included in the meta-analysis. The pooled mean temperature difference (rectal minus ear) was 0.29 degrees C (95% limits of agreement -0.74 to 1.32). We pooled data by ear device mode and the mean temperature differences were rectal mode 0.15 degrees C (-0.95 to 1.25), actual 0.70 degrees C (-0.20 to 1.60), core 0.25 degrees C (-0.78 to 1.27), oral 0.34 degrees C (-0.86 to 1.54), tympanic 0.62 degrees C (-0.40 to 1.64) and mode not stated 0.32 degrees C (-0.57 to 1.21). There was significant residual heterogeneity in both mean differences and sample SDs within the groups of ear device mode. INTERPRETATION: Although the mean differences between rectal and ear temperature measurements were small, the wide limits of agreement mean that ear temperature is not a good approximation of rectal temperature, even when the ear thermometer is used in rectal mode. Our finding suggests that infrared ear thermometry does not show sufficient agreement with an established method of temperature measurement to be used in situations where body temperature needs to be measured with precision.