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Medicina interna de México

versión impresa ISSN 0186-4866


SANCHEZ-DIAZ, JS et al. Fever in critically ill patient: To treat or not to treat?. Med. interna Méx. [online]. 2017, vol.33, n.1, pp.48-60. ISSN 0186-4866.

Fever is a common sign in the intensive care unit, this involves the challenge of discovering its cause, usually reflects the presence of infection, but may have no infectious origin or be conditioned by hyperthermia syndromes. The Infectious Diseases Society of America (IDSA) and the American College of Critical Care Medicine define fever in critically ill patients as temperature equal or greater than 38.3°C. Fever is a complex physiological reaction to a disease mediated increase of cytokines and generation of acute phase reactants. There are different methods to measure temperature; physicians should know the degree of accuracy and limitations of each. In the intensive care unit body temperature can be measured using different techniques among which the catheter in the pulmonary artery is considered the gold standard. Fever in critically ill patients can be classified into three main categories: hyperthermia syndromes, infectious origin and noninfectious. An episode of greater than or equal to 38.3°C temperature should be evaluated. The clinical history, physical examination and characteristics of fever (magnitude, duration, frequency and its relation to diagnostic or therapeutic interventions) are essential. There is controversy regarding the treatment of fever, current evidence gives a dual and opposite, benefits and harms, role depending on the situation.

Palabras llave : fever; intensive care unit; infectious; non-infectious origin; treatment.

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