Temperature management of non-elective intensive care patients without neurological abnormalities: a point prevalence study of practice in Australia and New Zealand.
OBJECTIVE
To determine the frequency of pharmacological and physical cooling in non-elective general intensive care unit patients without neurological abnormalities in Australia and New Zealand, and to establish the indications for antipyretics, the prevalence of fever, and the methods of temperature measurement.


METHODS
A point prevalence study conducted on two days in 2010, in 38 ICUs in Australia and New Zealand, examining non-elective (emergency) patients admitted with sepsis and other inflammatory abnormalities but without neurological abnormalities.


RESULTS
Of 506 general ICU patients surveyed on the study days, 311 had sepsis or other inflammatory abnormalities and no neurological abnormalities. These patients had a mean peak temperature of 37.3°C (SD, 0.8°C). In 100 patients (32.2%), the peak temperature was above 38°C. Paracetamol was the most common antipyretic used (152/311; 48.9%) and was administered for pain in 92/152 patients (60.5%), for pain and fever in 26/152 patients (17.1%), and for fever alone in 14/152 patients (9.2%). Patients who received paracetamol for fever had a mean peak recorded temperature of 38.3°C (SD, 0.8°C). Temperature measurements were mainly non-core (251/ 311; 81%) with axillary (116/311; 37%) and tympanic (110/ 311; 35%) measurements the most common.


CONCLUSIONS
Pharmacological antipyretics are used regularly for pain management rather than fever management, with paracetamol the most common antipyretic therapy. The use of NSAIDS and physical cooling is rare. Non-core temperature measurements were common.
Critical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australia. nhammond@georgeinstitute.org.au
Naomi E
NE
Hammond
Manoj K
MK
Saxena
Colman
C
Taylor
Paul
P
Young
Ian
I
Seppelt
Parisa
P
Glass
John
J
Myburgh
D058633:Antipyretics / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D001831:Body Temperature; D003422:Critical Care / Q000379:methods*; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D013817:Thermography / Q000379:methods*
D058633:Antipyretics