RT Journal Article SR Electronic T1 An adaptation strategy to urban heat: Hospital rooms with radiant cooling accelerate patient recovery JF ERJ Open Research JO erjor FD European Respiratory Society SP 00881-2020 DO 10.1183/23120541.00881-2020 A1 Christina Hoffmann A1 Uta Liebers A1 Philipp Humbsch A1 Marija Drozdek A1 Georg Bölke A1 Peter Hoffmann A1 Adrien Holzgreve A1 Gavin C. Donaldson A1 Christian Witt YR 2021 UL http://openres.ersjournals.com/content/early/2021/05/27/23120541.00881-2020.abstract AB Background Patients with respiratory diseases are vulnerable to the effects of heat. Therefore, it is important to develop adaptation strategies for heat exposure. One option is to optimise the indoor environment. To this end, we equipped hospital patient rooms with radiant cooling. We performed a prospective randomised clinical trial to investigate potentially beneficial effects of the hospitalisation in rooms with radiant cooling on patients with a respiratory disease exacerbation.Methods Recruitment took place in June, July, and August 2014 to 2016 in the Charité – Universitätsmedizin Berlin, Germany. We included patients with COPD, asthma, pulmonary hypertension, interstitial lung disease, and pneumonia. 62 patients were allocated to either a standard patient room without air conditioning or a room with radiant cooling set to 23 °C (73 °F). We analysed the patients’ length of stay with a Poisson regression. Physiological parameters, fluid intake, and daily step counts were tested with mixed regression models.Results Patients hospitalised in a room with radiant cooling were discharged earlier than patients in standard rooms (p=0.003). The study participants in chambers with radiant cooling had a lower body temperature (p=0.002), lower daily fluid intake (p<0.001), higher systolic blood pressure (p<0.001), and an increased daily step count (p<0.001).Conclusion The results indicate that a radiant cooling system in hospital patient rooms provides clinical benefits for patients with respiratory disease exacerbations during the warm summer months, which may contribute to an earlier mobilisation. Radiant cooling is commended as a suitable adaptation strategy to reduce the clinical impact of climate warming.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Hoffmann has nothing to disclose.Conflict of interest: Dr. Liebers reports personal fees for consultations and lectures from this companies: ASTRA ZENECA GmbH, Berlin-Chemie AG, Boehringer Ingelheim GmbH, Bristol-Myers Squibb , GlaxoSmithKline, Novartis Pharma GmbH, Roche Pharma AG.Conflict of interest: Mr. Humbsch has nothing to disclose.Conflict of interest: Dr. Drozdek has nothing to disclose.Conflict of interest: Dr. Bölke has nothing to disclose.Conflict of interest: Dr. Hoffmann has nothing to disclose.Conflict of interest: Dr. Holzgreve has nothing to disclose.Conflict of interest: Dr. Donaldson reports grants from Astra-Zeneca, personal fees from Astra-Zeneca, personal fees from American Thoracic Society, personal fees from FWO, Flanders, outside the submitted work; .Conflict of interest: Dr. Witt reports grants from Deutsche Forschungsgemeinschaft, during the conduct of the study; personal fees from MSD, personal fees from AstraZeneca, personal fees from Bristol-Myers Squibb, personal fees from GlaxoSmithKline, personal fees from Takeda, personal fees from BERLIN-CHEMIE, outside the submitted work; .