Fever During Pediatric Intensive Care Unit Admission Is Independently Associated With Increased Morbidity

Gordijn, Maartje S.; Plötz, Frans B.; Kneyber, Martin C. J.

doi:10.1177/0885066609340631

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…Based on the studies, the main cause of acute respiratory distress syndrome was sepsis. In addition, sepsis increased susceptibility to ventilator-induced lung injury (40, 41); therefore, the relationship between sepsis with the length of stay in PICU and mechanical ventilation is two sided.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study

et al. 2019

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Objective: The aim of this study was to investigate the level of resistin in children with and without sepsis hospitalized in the pediatric intensive care unit (PICU) and compare them to levels in healthy subjects in order to determine the trend of resistin levels in children in PICUs and also to identify the cut-off values for positive sepsis. Methods: This was a case-control study conducted in 2014 at a children's hospital in Tabriz, Iran. Three groups were investigated, a case group comprised of patients with sepsis admitted to PICU and two control groups; one made up of patients admitted to PICU without sepsis and the other of healthy children. Variables included demographic, anthropometric (growth metric percentile), and clinical factors. Results: Patients were randomized into control group A ( n = 12, 48%), control group B ( n = 11, 44%), and the sepsis group ( n = 24, 47.1%). The difference in the means of resistin levels was significant on the first, fourth, and seventh days ( P < 0.0001) in the case and control group A. Means comparisons in the case and control group B revealed significant differences on the fourth and seventh day ( P = 0.005 and P < 0.0001, respectively) but not on the first day ( P = 0.246). The trend of resistin levels increased in the septic group (F Huynh-Feldt = 37.83, P < 0.0001). The diagnostic accuracy of resistin level was high for discriminating sepsis (area under the receiver operating characteristic curve [AUC] 0.864 [SE = 0.41]). The sensitivity was 0.824 and specificity 0.72 with a cut-off point of 5.2 ng/ml on the first day. Conclusion: In the present study, resistin level can be used as an indicator of sepsis in children admitted to PICU. However, the cut-off point based upon when a prediction could be made is different and is dependent on a variety of factors, such as control group and number of days since the first signs of sepsis.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study

et al. 2019

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“…In a study of marathon runners, a water deficit of as little as 3% was associated with a rectal temperature greater than 39 C. 4 In a combined medical and surgical pediatric ICU (PICU), 40% of patients had a documented fever. 5 The vast majority (92%) had their first fever within 48 hours of admission, and the fever was generally related to the admission diagnosis. Fever after the first 48 hours was due to nosocomial infection (proven or suspected) and was associated with an increased length of stay (LOS) in the PICU.…”

Section: Fever In the Pediatric Cicumentioning

confidence: 99%

Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care

Axelrod

Alten

Berger

et al. 2015

World J Pediatr Congenit Heart Surg

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Since the inception of the Pediatric Cardiac Intensive Care Society (PCICS) in 2003, remarkable advances in the care of children with critical cardiac disease have been developed. Specialized surgical approaches, anesthesiology practices, and intensive care management have all contributed to improved outcomes. However, significant morbidity often results from immunologic or infectious disease in the perioperative period or during a medical intensive care unit admission. The immunologic or infectious illness may lead to fever, which requires the attention and resources of the cardiac intensivist. Frequently, cardiopulmonary bypass leads to an inflammatory state that may present hemodynamic challenges or complicate postoperative care. However, inflammation unchecked by a compensatory anti-inflammatory response may also contribute to the development of capillary leak and lead to a complicated intensive care unit course. Any patient admitted to the intensive care unit is at risk for a hospital acquired infection, and no patients are at greater risk than the child treated with mechanical circulatory support. In summary, the prevention, diagnosis, and management of immunologic and infectious diseases in the pediatric cardiac intensive care unit is of paramount importance for the clinician. This review from the tenth PCICS International Conference will summarize the current knowledge in this important aspect of our field.

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“…In the pediatric population, few reports investigate the role of fever in the ICU patient. Gordijn et al 2 pointed out in a retrospective observational study that 40% of the patients presented fever during their stay in the ICU, the majority within the first 48 h of admission and concerning the primary diagnosis. The fever that began after 48 h was associated with a longer stay.…”

Section: Fever In the Patient With Infectionmentioning

confidence: 99%

“…In the Intensive Care Unit (ICU), fever frequently occurs in both adults 1 and the pediatric 2 patients, although its origin can be diverse, sepsis is its leading cause, reaching 74% in hospitalized patients 3 , while in the pediatric population infectious pathologies represent 80% 4 . Fever should be regarded as an essential component of the host systemic inflammatory response, being an important defense and resistance mechanism against infections, by which the organism itself undergoes temporal thermal stress as a global regulatory mechanism 5 .…”

Section: Introductionmentioning

confidence: 99%

Fever and antipyretic therapy in the septic patient in the intensive care unit: an update

Donoso¹,

Arriaga²

2023

BMHIME

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Fever is a very common sign to observe in critically ill children during their Intensive Care Unit stay, which should be understood as an evolutionary biological response of normal adaptive character from the host to physiological stress. It is the result of a complex response to pyrogenic stimuli, resulting in the generation of cytokines and prostaglandins. The molecular mechanisms involved in the onset of fever are not yet fully specified. Therefore, difficulties in the knowledge of the exact pathophysiological processes involved are created, so it is necessary to elaborate an adequate and specific therapeutic strategy. Experimental studies conclude that fever and inflammation are beneficial to the host. However, antipyretic therapy is commonly employed, and human studies on the presence of fever and its treatment for the prognosis of critically ill septic patients are inconclusive. Up-to-date information on the physiology of human thermoregulation, the effect of temperature on the febrile range over multiple biological processes involved in host defense, and thermoregulatory interventions in the septic patient are essential to know by the critical care physician.

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Fever During Pediatric Intensive Care Unit Admission Is Independently Associated With Increased Morbidity

Abstract: Fever in critically ill children occurs frequently during PICU stay. Fever after 48 hours of admission or new episodes of fever after 48 nonfebrile hours were mainly caused by nosocomial infections and was independently associated with prolonged length of ventilatory support and PICU stay.

Cited by 8 publications

References 17 publications

Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study

Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study

Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care

Fever and antipyretic therapy in the septic patient in the intensive care unit: an update

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