The Evaluation Of Fever In The Intensive Care Unit

Almost all febrile ICU patients are treated with acetaminophen and external cooling methods to render the patients “a febrile.” However, fever is a basic evolutionary response to infection and may be an important host defense mechanism. The preponderance of evidence suggests that temperature in the range of the usual fever renders host defenses more active and many pathogens more susceptible to these defenses. Therefore, it seems illogical to treat fever per se .Based on this data, it is recommended that febrile episodes not be routinely treated with antipyretic therapy; an evaluation of the relative benefits and risks of antipyretic treatment should be evaluated in each individual case. Fever should, however, be treated in patients with acute brain insults, patients with limited cardiorespiratory reserve (i.e., ischemic heart disease), and in patients in whom the temperature increases above 40°C (104°F).3,4,9,10,11 also external cooling may result in augmented hypermetabolism and a persistent fever and it has been demonstrated that active external cooling in volunteers with induced fever increased oxygen consumption by 35 to 40% and was associated with a significant increase in epinephrine and norepinephrine levels.Thus it is of utmost importance that fever should be evaluated before the patient is submitted to any line of treatment.