Is it worth treating fever in intensive care unit patients? Preliminary results from a randomized trial of the effect of external cooling.
BACKGROUND
Antipyresis is a common clinical practice in intensive care, although it is unknown if fever is harmful, beneficial, or a negligible adverse effect of infection and inflammation.


METHODS
In a randomized study, rectal temperature and discomfort were assessed in 38 surgical intensive care unit patients without neurotrauma or severe hypoxemia and with fever (temperature >/=38.5 degrees C) and systemic inflammatory response syndrome. Eighteen patients received external cooling while 20 received no antipyretic treatment.


RESULTS
Temperature and discomfort decreased similarly in both groups after 24 hours. No significant differences in recurrence of fever, incidence of infection, antibiotic therapy, intensive care unit and hospital length of stay, or mortality were noted between the groups.


CONCLUSIONS
These results suggest that the systematic suppression of fever may not be useful in patients without severe cranial trauma or significant hypoxemia. Letting fever take its natural course does not seem to harm patients with systemic inflammatory response syndrome or influence the discomfort level and may save costs.
Gozzoli
V
V
Division of Surgical Intensive Care, University Hospital of Geneva, CH-1211 Geneva 14-Switzerland.
Schöttker
P
P
Suter
P M
PM
Ricou
B
B
D000704:Analysis of Variance; D001831:Body Temperature; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D005334:Fever / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012007:Rectum / Q000502:physiology; D012008:Recurrence