• Benjamin Assouline, Gianlucca Belli, Karim Dorgham, Quentin Moyon, Alexandre Coppens, Pineton de ChambrunMarcMSorbonne Université, Service de Médecine Intensive Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, France; INSERM UMRS_1166-iCAN, Institute of Cardiometabolism and Nutrition, Paris, Franc, Juliette Chommeloux, David Levy, Ouriel Saura, Guillaume Hekimian, Matthieu Schmidt, Alain Combes, and Charles-Edouard Luyt.
• Sorbonne Université, Service de Médecine Intensive Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, France.
• J Crit Care. 2025 Feb 1; 85: 154945154945.

PurposeFever is frequent after extracorporeal membrane oxygenation (ECMO) decannulation. We aimed to evaluate the incidence of post-decannulation fever and describe its causes.MethodsAdult 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.ResultsBetween 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.ConclusionPost-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.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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