{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:11:03Z","timestamp":1768457463300,"version":"3.49.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether ICU temperature management strategy is associated with fever in children with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a single-center retrospective cohort study at a quaternary Children's hospital between 1\/1\/2016\u201331\/12\/2020. Mechanically ventilated children (&amp;lt;18 y\/o) admitted to Pediatric or Cardiac ICU (PICU\/CICU) with ROSC after OHCA who survived at least 72\u2005h were included. Primary exposure was initial PICU\/CICU temperature management strategy of: (1) passive management; or (2) warming with an air-warming blanket; or (3) targeted temperature management with a heating\/cooling (homeothermic) blanket. Primary outcome was fever (\u226538\u00b0C) within 72\u2005h of admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period, 111 children with ROSC after OHCA were admitted to PICU\/CICU, received mechanical ventilation and survived at least 72\u2005h. Median age was 31 (IQR 6\u2013135) months, 64% (71\/111) were male, and 49% (54\/111) were previously healthy. Fever within 72\u2005h of admission occurred in 51% (57\/111) of patients. The choice of initial temperature management strategy was associated with occurrence of fever (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20099.36, df\u2009=\u20092, <jats:italic>p<\/jats:italic>\u2009=\u20090.009). Fever occurred in 60% (43\/72) of patients managed passively, 45% (13\/29) of patients managed with the air-warming blanket and 10% (1\/10) of patients managed with the homeothermic blanket. Compared to passive management, use of homeothermic, but not of air-warming, blanket reduced fever risk [homeothermic: Risk Ratio (RR)\u2009=\u20090.17, 95%CI 0.03\u20130.69; air-warming: RR\u2009=\u20090.75, 95%CI 0.46\u20131.12]. To prevent fever in one child using a homeothermic blanket, number needed to treat (NNT)\u2009=\u20092.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In critically ill children with ROSC after OHCA, ICU temperature management strategy is associated with fever. Use of a heating\/cooling blanket with homeothermic feedback reduces fever incidence during post-arrest care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1355385","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T05:06:47Z","timestamp":1712725607000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of temperature management strategy with fever in critically ill children after out-of-hospital cardiac arrest"],"prefix":"10.3389","volume":"12","author":[{"given":"Micah","family":"Kadden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Shoykhet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.resuscitation.2016.07.244","article-title":"Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America","volume":"107","author":"Fink","year":"2016","journal-title":"Resuscitation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.annemergmed.2005.05.028","article-title":"Out-of-hospital pediatric cardiac arrest: 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