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- Open Access
A survey of fever management in febrile intensive care patients without neurological injury
© Saxena et al. 2011
- Published: 27 October 2011
- Temperature Threshold
- Neurological Injury
- Physical Intervention
- Intensive Care Patient
- Sterile Inflammation
Fever is a common observation during critical illness [1, 2] and may be due to many possible causes such as infection, sterile inflammation and neurological injury. Clinical trials of fever management lack sufficient methodological quality to answer the question of whether attempts at reduction in temperature improves patient-centred outcomes in patients with sepsis, inflammation or neurological injury [3–7]. We undertook a survey to describe the attitudes of critical care clinicians in Australia and New Zealand towards fever management in critically ill patients without neurological injury or hyperthermic syndromes.
An online scenario-based questionnaire survey was distributed to medical and nursing members of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS-CTG) and their intensive care colleagues. Main outcome measures: the choice of drug and preferred threshold temperature for intervention with antipyretics in clinical practice and in a clinical trial.
Preference of first-line and second-line interventional category of antipyretic by profession
First line (n= 418)
Second line (n= 409)
Pharmacological and physical
This survey suggests there is considerable clinical variability in fever management in patients with sepsis and without neurological injury or hyperthermic syndromes. At present, no particular management strategy is known to be superior to any other and it remains possible that current practice may be harming substantial numbers of patients. A temperature threshold of up to 40°C may be acceptable to clinicians for the design of a future randomized controlled trial. Further observational data may be informative for the design of such clinical trials.
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