Matt Harmon

61 Chapter three a decreased ability to mount an adequate host response (those on steroids, those with immunodeficiency) and patients at risk for iatrogenic hypothermia (patients derived directly from the OR). Multiple testing can cause confounding. However after Bonferroni correction fractalkine remained significantly associated with hypothermia. Also, as fractalkine was significantly elevated at all time-points and remained significant after matching for disease severity, we consider these results to be valid. Lastly, this is an observational study and cause-effect relationships cannot be established due to the nature of this study design. Conclusions In conclusion, hypothermia during sepsis is independently associated with 90-day mortality. However, neither the etiology of hypothermia or increased mortality due to hypothermia are explained by a dysfunctional hostimmune response. Low BMI, hypertension and chronic cardiovascular insufficiency are risk factors for hypothermic sepsis. Hypothermia is associated with increased levels of the endothelial derived biomarker fractalkine. The functional role of fractalkine and the endothelium in the context of hypothermic sepsis requires further study. Acknowledgements The authors acknowledge all members of the MARS consortium for the participation in data collection and especially acknowledge: Friso M. de Beer, MD, Lieuwe D. J. Bos, PhD (Department of Intensive Care, Academic Medical Center, University of Amsterdam), Jos F. Frencken, MD (Department of Intensive Care Medicine and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands), Gerie J. Glas, MD, Roosmarijn T. M. van Hooijdonk, MD, PhD (Department of Intensive Care, Academic Medical Center, University of Amsterdam), Mischa A. Huson, MD (Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam), Peter M.C. Klein Klouwenberg, MD, PharmD, PhD, David S. Y. Ong, MD, PharmD (Department of Intensive Care Medicine, Julius Center for Health Sciences and Primary Care and Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands), Laura R. A. Schouten, MD (Department of Intensive Care, Academic Medical Center, University of Amsterdam), Marleen Straat, MD, Esther Witteveen, MD, and Luuk Wieske, MD, PhD (Department of Intensive Care, Academic Medical Center, University of Amsterdam).