Persistent fever in the ICU

Tayyab Rehman; Bennett P deBoisblanc

doi:10.1378/chest.12-2843

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Journal article

Peer reviewed

Persistent fever in the ICU

Tayyab Rehman and Bennett P deBoisblanc

Chest, Vol.145(1), pp.158-165

01/2014

DOI: 10.1378/chest.12-2843

PMID: 24394828

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Abstract

Disorders of elevated body temperature may be classified as either fever or hyperthermia. Fever is caused by a pyrogen-mediated upward adjustment of the hypothalamic thermostat; hyperthermia results from a loss of physiologic control of temperature regulation. Fever in the ICU can be due to infectious or noninfectious causes. The initial approach to a febrile, critically ill patient should involve a thoughtful review of the clinical data to elicit the likely source of fever prior to the ordering of cultures, imaging studies, and broad-spectrum antibiotics. Both high fever and prolonged fever have been associated with increased mortality; however, a causal role for fever as a mediator of adverse outcomes during non-neurologic critical illness has not been established. Outside the realm of acute brain injury, the practice of treating fever remains controversial. To generate high-quality, evidence-based guidelines for the management of fever, large, prospective, multicenter trials are needed.

Acalculous Cholecystitis - complications

Humans

Fever - therapy

Malignant Hyperthermia - complications

Urinary Tract Infections - complications

Malignant Hyperthermia - therapy

Serotonin Syndrome - complications

Cross Infection - complications

Sinusitis - complications

Enterocolitis, Pseudomembranous - complications

Venous Thromboembolism - complications

Neuroleptic Malignant Syndrome - therapy

Catheterization, Central Venous - adverse effects

Acalculous Cholecystitis - surgery

Pneumonia, Ventilator-Associated - drug therapy

Intensive Care Units

Bacteremia - complications

Bacteremia - drug therapy

Neuroleptic Malignant Syndrome - complications

Cross Infection - drug therapy

Urinary Tract Infections - drug therapy

Catheter-Related Infections - drug therapy

Serotonin Syndrome - therapy

Enterocolitis, Pseudomembranous - drug therapy

Pneumonia, Ventilator-Associated - complications

Fever - etiology

Catheter-Related Infections - complications

Venous Thromboembolism - therapy

Sinusitis - drug therapy

Details

Title: Subtitle: Persistent fever in the ICU
Creators: Tayyab Rehman - Section of Pulmonary & Critical Care Medicine, Department of Medicine, LSU Health Sciences Center, New Orleans, LA
Bennett P deBoisblanc - Section of Pulmonary & Critical Care Medicine, Department of Medicine, LSU Health Sciences Center, New Orleans, LA. Electronic address: bdeboi@lsuhsc.edu
Resource Type: Journal article
Publication Details: Chest, Vol.145(1), pp.158-165
DOI: 10.1378/chest.12-2843
PMID: 24394828
ISSN: 0012-3692
eISSN: 1931-3543
Language: English
Date published: 01/2014
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094218802771

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