Body temperature abnormalities in non-neurological critically ill patients: a review of the literature

Abstract

Body temperature abnormalities, which occur because of several infectious and non-infectious etiologies, are among the most commonly noted symptoms of critically ill patients. These abnormalities frequently trigger changes in patient management. The purpose of this article was to review the contemporary literature investigating the definition and occurrence of body temperature abnormalities in addition to their impact on illness severity and mortality in critically ill non-neurological patients, particularly in patients with severe sepsis. Reports on the influence of fever on outcomes are inconclusive, and the presence of fever per se may not contribute to increased mortality in critically ill patients. In patients with severe sepsis, the impacts of elevated body temperature and hypothermia on mortality and the severity of physiologic decline are different. Hypothermia is significantly associated with an increased risk of mortality. In contrast, elevated body temperature may not be associated with increased disease severity or risk of mortality. In patients with severe sepsis, the effect of fever and fever control on outcomes requires further research.

Comparison of the effects of whole-body cooling during fatiguing exercise in males and females

“…However, it is not known whether males and females respond differently to fatiguing exercise after whole-body cooling. Given that most studies on endurance performance after cooling have been performed in males and the apparent sex differences in the response to cold stress, this study aimed to determine whether whole-body cooling has sex-specific effects on performance during fatiguing exercise within normothermic limits (up to 35.5° [21] …”

Outcome of severe infections in afebrile neutropenic cancer patients

“…Even more, published data shows that non-neutropenic patients with afebrile severe infections, especially those with hypothermia, have higher mortality rates compared to febrile non-neutropenic patients. 8,16,17 …”

Physical methods for the treatment of fever in critically ill patients: a randomized controlled trial

“…Tympanic temperature was measured at 15-minute intervals during 3 hours from the moment of applying the intervention in all intervention groups. Tympanic temperature reduction was considered a value < 38.3°C, as a patient hospitalized in the ICU in a fevered state is considered to have a body temperature ≥ 38.3°C (3) . The ambient internal and external minimum and maximum temperature was monitored in the two units (ICU and surgical clinic) during all data collection using a model 7427.03.0.00 Incoterm® digital thermometer, and values were maintained between 24°C and 28°C.…”

“…Due to the high risk of infection associated with invasive procedures, immunosuppression, pathological conditions and environmental risks present in intensive care units (ICU), fevers occur in more than one-third of critical patients (2) . It is therefore a frequent event in this type of unit, with over 50% of individuals admitted to ICU presenting fevers due to infectious or non-infectious causes (1,3) . Literature indicates that due to hemodynamic instability that critical patients may present, fever is a symptom that should be eliminated or reduced with drug treatment, and should also be associated or not to physical methods with patients presenting this profile (2,4) .…”