V Gozzoli1, P Schöttker, P M Suter, B Ricou. 1. Division of Surgical Intensive Care, University Hospital of Geneva, CH-1211 Geneva 14-Switzerland.
Abstract
BACKGROUND: Antipyresis is a common clinical practice in intensive care, although it is unknown if fever is harmful, beneficial, or a negligible adverse effect of infection and inflammation. METHODS: In a randomized study, rectal temperature and discomfort were assessed in 38 surgical intensive care unit patients without neurotrauma or severe hypoxemia and with fever (temperature >/=38.5 degrees C) and systemic inflammatory response syndrome. Eighteen patients receivedexternal cooling while 20 received no antipyretic treatment. RESULTS:Temperature and discomfort decreased similarly in both groups after 24 hours. No significant differences in recurrence of fever, incidence of infection, antibiotic therapy, intensive care unit and hospital length of stay, or mortality were noted between the groups. CONCLUSIONS: These results suggest that the systematic suppression of fever may not be useful in patients without severe cranial trauma or significant hypoxemia. Letting fever take its natural course does not seem to harm patients with systemic inflammatory response syndrome or influence the discomfort level and may save costs.
RCT Entities:
BACKGROUND: Antipyresis is a common clinical practice in intensive care, although it is unknown if fever is harmful, beneficial, or a negligible adverse effect of infection and inflammation. METHODS: In a randomized study, rectal temperature and discomfort were assessed in 38 surgical intensive care unit patients without neurotrauma or severe hypoxemia and with fever (temperature >/=38.5 degrees C) and systemic inflammatory response syndrome. Eighteen patients received external cooling while 20 received no antipyretic treatment. RESULTS: Temperature and discomfort decreased similarly in both groups after 24 hours. No significant differences in recurrence of fever, incidence of infection, antibiotic therapy, intensive care unit and hospital length of stay, or mortality were noted between the groups. CONCLUSIONS: These results suggest that the systematic suppression of fever may not be useful in patients without severe cranial trauma or significant hypoxemia. Letting fever take its natural course does not seem to harm patients with systemic inflammatory response syndrome or influence the discomfort level and may save costs.
Authors: Nicholas M Mohr; Brian M Fuller; Lee P Skrupky; Hawnwan Moy; Robert Alunday; Scott T Micek; Richard E Fagley Journal: Ann Pharmacother Date: 2011-09-20 Impact factor: 3.154
Authors: Nicholas Mohr; Lee Skrupky; Brian Fuller; Hawnwan Moy; Robert Alunday; Michael Wallendorf; Scott Micek; Richard Fagley Journal: Intern Emerg Med Date: 2012-08-28 Impact factor: 3.397