Document Detail


Hyperthermia in the neurosurgical intensive care unit.
MedLine Citation:
PMID:  11014424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In patients with traumatic or ischemic brain injury, hyperthermia is thought to worsen the neurological injury. We studied fever in the neurosurgical intensive care unit (ICU) population using a definition common to surgical practice (rectal temperature >38.5 degrees C). We sought to determine fever incidence, fever duration, and peak temperature and to quantify the use of antipyretic therapy. We also attempted to determine the patient subgroups that are at highest risk for development of fever. METHODS: In a retrospective chart review of a 6-month period, all febrile episodes that occurred in a consecutive series of neurosurgical ICU patients in a university hospital setting were studied. A febrile episode was defined as a rectal temperature of at least 38.5 degrees C; an episode lasted until the temperature fell below this threshold. RESULTS: The 428 patients studied had 946 febrile episodes. Fever occurred in 47% of patients, with a mean of 4.7 febrile episodes in each febrile patient. Fevers occurred in more than 50% of patients who were admitted to the ICU for subarachnoid hemorrhage, a central nervous system infection, seizure control, or hemorrhagic stroke, but they occurred in only 27% of patients admitted for spinal disorders. Fevers occurred in 15% of the patients who stayed in the ICU less than 24 hours, but in 93% of those who remained longer than 14 days. Despite the use of antipyretic therapy for 86% of the febrile episodes, 57% lasted longer than 4 hours and 5% lasted longer than 12 hours. CONCLUSION: Fever is common in critically ill neurosurgical patients, especially those with a prolonged length of stay in the ICU or a cranial disease. If hyperthermia worsens the functional outcome after a primary ischemic or traumatic injury, as has been suggested by several studies of stroke patients, treatment of fever is a clinical issue that requires better management.
Authors:
M M Kilpatrick; D W Lowry; A D Firlik; H Yonas; D W Marion
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  47     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-08     Completed Date:  2001-01-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  850-5; discussion 855-6     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Non-Narcotic / therapeutic use
Fever* / drug therapy,  epidemiology*,  physiopathology*
Humans
Incidence
Intensive Care Units*
Length of Stay
Neurosurgical Procedures*
Pennsylvania
Retrospective Studies
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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