Medizinische Klinik, Intensivmedizin und Notfallmedizin | 2019
[Fever in the critically ill : To treat or not to treat].
Abstract
Fever, arbitrarily defined as a core body temperature >38.3\u202f°C, is present in 20-70\u202f% of intensive care unit patients. Fever caused by infections is a\xa0physiologic reset of the thermostatic set-point and is associated with beneficial consequences, but may have negative sequelae with temperatures >39.5\u202f°C. Fever of non-infectious and neurologic origin affects about 50\u202f% of patients with elevated body temperature, presents as a\xa0pathologic loss of thermoregulation, and may be associated with untoward side effects at temperatures above 38.5-39.0\u202f°C. Cooling can be achieved by physical and pharmacologic means. Evidence-based recommendations are not available. The indication for a\xa0cooling therapy can only be based on the physiologic reserve and the neurologic, hemodynamic, and respiratory state. The temperature should be lowered to the normothermic range. Hyperthermia syndromes require immediate physical cooling (and dantrolen when indicated).