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Is It Worth Treating Fever in Intensive Care Unit Patients?
Preliminary Results From a Randomized Trial of the Effect of External Cooling
Valerio Gozzoli, MD;
Patrick Schöttker, MD;
Peter M. Suter, MD;
Bara Ricou, MD
Arch Intern Med. 2001;161:121-123.
Background Antipyresis is a common clinical practice in intensive care, although
it is unknown if fever is harmful, beneficial, or a negligible adverse effect
of infection and inflammation.
Methods In a randomized study, rectal temperature and discomfort were assessed
in 38 surgical intensive care unit patients without neurotrauma or severe
hypoxemia and with fever (temperature  38.5°C) and systemic inflammatory
response syndrome. Eighteen patients received external cooling while 20 received
no antipyretic treatment.
Results Temperature and discomfort decreased similarly in both groups after
24 hours. No significant differences in recurrence of fever, incidence of
infection, antibiotic therapy, intensive care unit and hospital length of
stay, or mortality were noted between the groups.
Conclusions These results suggest that the systematic suppression of fever may not
be useful in patients without severe cranial trauma or significant hypoxemia.
Letting fever take its natural course does not seem to harm patients with
systemic inflammatory response syndrome or influence the discomfort level
and may save costs.
From the Division of Surgical Intensive Care, Department of Anaesthesiology,
Pharmacology, and Surgical Intensive Care, University Hospital of Geneva,
Geneva, Switzerland.
Corresponding author and reprints: Bara Ricou, MD, Division of Surgical
Intensive Care, University Hospital of Geneva, CH-1211 Geneva 14-Switzerland
(e-mail: bara.ricou{at}hcuge.ch).
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