TandemHeart-Associated Fever: Does the Fever Signify Infection?

Percutaneous mechanical circulatory support devices such as TandemHearts have been increasingly used in the treatment of patients with refractory cardiogenic shock. Fever can develop as a consequence without the development of an infection. Infectious disease physicians are commonly consulted for the onset of fevers after device placement, and it is been a challenge to identify the cause of fevers and delineate infection as cause of fever. Fever and associated infections have not been well characterized after TandemHeart placement. The aim of the current study is to correlate the development of fever with infections and describe the infectious complications associated with TandemHearts. The study included patients who received TandemHearts between 2013 and 2016. Data on demographics, indication for insertion, fever course if noted within 72 hours after the device placement, infection type, and outcome were collected. Among the included 52 patients, fever was noted in 23 (44.2%) and infections in 15 (29%) patients, and both fever and infection in 5 patients. The median onset of fever was 26 hours, and the median onset of infection was 72 hours after insertion. Fever without any documented infection was noted in 18 of 23 (78%). The median duration of fever in patients without infection was 18.5 hours, and that in patients with infection was 96 hours (P = 0.12). Infections included pneumonia in 7 of 15 (46.6%) and central line–associated blood stream infection in 4 of 15 (25%)...
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Original Article Source Type: research