Sánchez DJS, Rodríguez ZC, Monares ZE, Díaz EA, Aguirre SJ, Franco GJ

Language: Spanish
References: 9
Page: 33-38
PDF size: 220.39 Kb.

ABSTRACT

Background: Fever is a common sign in the intensive care unit; this involves the challenge of discovering the underlying cause, since it may have an infectious or non-infectious origin. The American College of Critical Care Medicine and the Infectious Diseases Society of America define «fever» in critically ill patients as a temperature equal to or greater than 38.3 ^oC, which involves investigating the cause. In the intensive care unit, temperature can be measured using different techniques, among which are the pulmonary artery catheter (gold standard), bladder catheter, rectal probe, gavage, infrared tympanic thermometer and temporal artery thermometer. A new episode of temperature equal to or greater than 38.3 ^oC should be clinically evaluated, but not necessarily with laboratory studies. There is controversy about the treatment of fever. The antipyretic approach should be reserved for patients with hemodynamic instability or those high-risk; a diagnostic evaluation and blood cultures should be performed. Objective: To differentiate infectious causes from noninfectious ones that commonly cause fever in the intensive care unit. Methods: A review was conducted on the topic «fever in the intensive care unit». The search was performed in electronic databases (PubMed, MD Consult) until September 2014. Systematic reviews considered the most important of the last 14 years were included. Results: Through this review, we were able to propose two algorithms in relation to this issue, the first refers to the causes of fever and the second, to the diagnostic approach of fever; their importance lies in their use and correct application of thereof. Conclusion: In the intensive care unit, temperature can be measured using different techniques, being the pulmonary artery catheter the gold standard. 50% of the patients in the intensive care unit present fever; only half of them with an infectious origin. The antipyretic treatment should be reserved for patients with acute neurological injury, hemodynamic instability and those high risk.

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