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Feb 3, 2023 · Pyrexia (fever) refers to a raised body temperature, typically greater than 37.5c. It is common in surgical patients, either normal immediate post-operative response or as feature of a specific post-operative complication. Whilst infection is regularly the suspected cause, other conditions must be considered when approaching the surgical ...
- Temperature Target
- Efficacy and Risks of Antipyretic Methods
- Paracetamol
- Non-Steroidal Anti-Inflammatory Agents
- Surface Cooling Devices
- Endovascular Cooling Devices
- Thermal Tolerance of Cooling
Different approaches to fever treatment have been proposed: 1. Control of pyrexia when it occurs: treatment administered when temperature exceeds a predefined threshold 2. Strict avoidance of pyrexia: temperature maintained below fever threshold 3. Strict maintenance of normothermia: TTM with a predefined normothermia range, e.g., 36–37 °C. The abs...
Antipyretic agents, mainly paracetamol and NSAIDs, and physical cooling methods can be used to control pyrexia. Cooling with surface devices is usually preferred for fever control while endovascular methods are more commonly restricted to therapeutic hypothermia. Infusions of cold fluids are easy to administer and inexpensive but this strategy expo...
Paracetamol is the most commonly administered antipyretic in clinical practice . Compared with placebo or no treatment, the difference in body temperature usually reaches statistical significance, although this is modest with uncertain clinical significance. In patients with brain injury, a standard dose (3 g/day) of paracetamol is often reported a...
NSAIDs are regularly used in the ICU despite the lack of adequate safety evaluation. NSAIDs have a well known side effect profile including hypotension, impaired hepatic and renal function, sodium and water retention, gastrointestinal bleeding and platelet dysfunction. In an attempt to avoid some of these effects, low dose continuous infusion of di...
Three main types of surface cooling devices are available: air-circulating blankets, water circulating blankets and hydrogel-coated water-circulating pads . There is no evidence to support the use of fans for temperature control. Fans are usually considered to help with patient comfort but they can induce shivering . In febrile ICU patients, air-ci...
Several intravenous heat exchange catheter devices are available for temperature management . Endovascular cooling was initially evaluated for therapeutic hypothermia. Some controlled studies are now available in patients with acute brain injury managed with controlled normothermia. The obvious disadvantage is their associated risks, which are like...
Any decrease in core and/or peripheral temperature will result in vasoconstriction followed by shivering. In normal and febrile conditions, shivering commences at a body core temperature of ≈1.5 °C under the hypothalamic set point . Skin temperature accounts for around 20 % of thermoregulation and cold stress can promote shivering while the core te...
- James F. Doyle, Frédérique Schortgen
- 2016
Pyrexia: An update on importance in clinical practice. Pyrexic patients are usually attended with some scepticism by anaesthesiologists. Main reasons are the absence of comprehensible guidelines pertaining to anaesthesia in such patients and the presence of innumerable aetiologies of pyrexia. This article has tried to fill the existing void in ...
- Ragi Jain, Deepesh Saxena
- 10.4103/0019-5049.154996
- 2015
- Indian J Anaesth. 2015 Apr; 59(4): 207-211.
Sep 1, 2016 · Pyrexia commonly triggers a full septic work-up, but on its own is a poor predictor of culture-positivity. In order to improve culturing practices, and better guide the diagnostic approach to critically ill patients with pyrexia, additional research is required to provide more robust estimates of the incidence of infectious and noninfectious ...
- Daniel J. Niven, Daniel J. Niven, Kevin B. Laupland
- 10.1186/s13054-016-1406-2
- 2016
- Crit Care. 2016; 20(1): 247.
Classic adult pyrexia of unknown origin is fever of 38.3°C or greater for at least 3 weeks with no identified cause after three days of hospital evaluation or three outpatient visits Common causes are infections, neoplasms, and connective tissue disorders A thorough history and physical examination, along with basic investigations will usually
Jan 3, 2024 · Fever is common in the first few days after major surgery and can pose a diagnostic challenge for the care team. While the definition of fever is variable, many use 38°C (100.4°F) as the threshold, although this can be hospital and unit specific [ 1-3 ]. Most early postoperative fever is caused by the inflammatory stimulus of tissue damage ...
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Aug 21, 2023 · A fever is considered low-grade if your temperature is one or two degrees above the normal reading of 98.6 degrees F. While it might not be a serious fever, it’s still best to let your healthcare provider know if you have a low-grade fever after surgery. A fever of 99 F is very common, especially in the first week while your incision is ...
