Diagnosis and management of temperature abnormality in ICUs: A EUROBACT investigators' survey

Niven, Daniel J, Laupland, Kevin B, Tabah, Alexis, Vesin, Aurélien, Rello, Jordi, Koulenti, Despoina, Dimopoulos, George, de Waele, Jan and Timsit, Jean-Francois (2013) Diagnosis and management of temperature abnormality in ICUs: A EUROBACT investigators' survey. Critical Care, 17 6: R289.1-R289.8. doi:10.1186/cc13153

Author Niven, Daniel J
Laupland, Kevin B
Tabah, Alexis
Vesin, Aurélien
Rello, Jordi
Koulenti, Despoina
Dimopoulos, George
de Waele, Jan
Timsit, Jean-Francois
Title Diagnosis and management of temperature abnormality in ICUs: A EUROBACT investigators' survey
Journal name Critical Care   Check publisher's open access policy
ISSN 1364-8535
Publication date 2013-12
Year available 2013
Sub-type Article (original research)
DOI 10.1186/cc13153
Open Access Status DOI
Volume 17
Issue 6
Start page R289.1
End page R289.8
Total pages 8
Place of publication Philadelphia, United States
Publisher Current Science Inc.
Collection year 2014
Language eng
Formatted abstract
Introduction: Although fever and hypothermia are common abnormal physical signs observed in patients admitted to intensive care units (ICU), little data exist on their optimal management. The objective of this study was to describe contemporary practices and determinants of management of temperature abnormalities among patients admitted to ICUs.

Methods: Site leaders of the multi-national EUROBACT study were surveyed regarding diagnosis and management of temperature abnormalities among patients admitted to their ICUs.

Results: Of the 162 ICUs originally included in EUROBACT, responses were received from 139 (86%) centers in 23 countries in Europe (117), South America (8), Asia (5), North America (4), Australia (3) and Africa (2). A total of 117 (84%) respondents reported use of a specific temperature threshold in their ICU to define fever. A total of 14 different discrete levels were reported with a median of 38.2°C (inter-quartile range, IQR, 38.0°C to 38.5°C). The use of thermometers was protocolized in 91 (65%) ICUs and a wide range of methods were reportedly used, with axillary, tympanic and urinary bladder sites as the most common as primary modalities. Only 31 (22%) of respondents indicated that there was a formal written protocol for temperature control among febrile patients in their ICUs. In most or all cases practice was to control temperature, to use acetaminophen, and to perform a full septic workup in febrile patients and that this was usually directed by physician order. While reported practice was to treat nearly all patients with neurological impairment and most patients with acute coronary syndromes and infections, severe sepsis and septic shock, this was not the case for most patients with liver failure and fever.

Conclusions: A wide range of definitions and management practices were reported regarding temperature abnormalities in the critically ill. Documenting temperature abnormality management practices, including variability in clinical care, is important to inform planning of future studies designed to optimize infection and temperature management strategies in the critically ill.
Keyword Bacteremia
Intensive care unit
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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