Intérêt du Traitement de la fièvre Par Refroidissement Externe Pour la Survie Des Patients ventilés en Choc Septique
The best strategy for managing fever in patients with septic shock remains unknown. In a pilot study, the investigators showed that fever control at normothermia allowed a better control of shock and evolution of organ failures. In this second trial the investigators will conduct a multicentre, open-label, randomized controlled, superiority trial in which two strategies will be compared: 1. Respect of fever 2. Fever control at normothermia using external cooling The primary end point will be d-60 mortality.
• Documented or suspected infection either communautary or hospital acquired
• Septic shock defined by the need for vasopressor and lactate\>2 mmol/l despite adequate fluid resuscitation (sepsis-3 definition)
• Patients under invasive mechanical ventilation
• Body core temperature\>38.3°C
• Intravenous sedation or opioids
• Ongoing antimicrobial treatment and/or intervention for infection source control
• Attending physician confirms clinical equipoise without substantial risk if the patient participates in the trial
• Informed consent of next of kin/other designated person before inclusion or procedure for inclusion in emergency situation