Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America

Abstract

The panel concluded that, because fever can have many infectious and noninfectious etiologies, a new fever in a patient in the intensive care unit should trigger a careful clinical assessment rather than automatic orders for laboratory and radiologic tests. A cost-conscious approach to obtaining cultures and imaging studies should be undertaken if indicated after a clinical evaluation. The goal of such an approach is to determine, in a directed manner, whether infection is present so that additional testing can be avoided and therapeutic decisions can be made.

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

“…Thus, these markers cannot be recommended distinguishing between severe infection and other acute inflammatory states [69], but they can be helpful adjunctive diagnostic markers to be interpreted in context with information from careful medical history, physical examination.…”

“…Thus, the main aims that should guide the choice of antiinfective treatments are [69,70]: Table 5 Proposals from the literature of empiric antibiotic antimicrobial choice based on suspected site of infection.…”

An observational study of a wireless temporal artery bandage thermometer

“…Agreement between the two devices was better for normothermia (36.0°C to \38.3°C) (mean 0.28°C; 95% CI, 0.21°C to 0.35°C) than for hypothermia (\36°C) (mean difference 0.88°C; 95% CI, 0.75°C to 1.01°C) 5 or for hyperthermia (C38.3°C) (mean difference -0.71°C; 95% CI, -0.88°C to -0.55°C). 1 The range of readings was 35.4 to 41.8°C for the bladder thermometer and 25.1°C to 45.6°C for WiTAT. The sensitivity for detecting hyperthermia using WiTAT was 0.49 (95% CI, 0.42 to 0.56) and the specificity was 0.83 (95% CI, 0.81 to 0.86).…”

“…1,2 However, measuring temperature in these locations is invasive and impractical for most patients. 1 A simple reliable accurate and non-invasive method for measuring temperature is needed in clinical practice. Finvers et al developed a novel non-invasive continuous temperature assessment method using a wireless temporal artery bandage thermometer (WiTAT).…”

“…Perhaps these results are not surprising given that skin temperature is affected by factors unrelated to core temperature, including regional perfusion and moisture. 1 The WiTAT is a novel noninvasive thermometer designed to provide wireless (allowing for remote patient monitoring) and continuous monitoring (eliminating the risk of missing important temperature changes). However, our data suggest that this new technology in its current form does not agree sufficiently with established methods of core temperature measurement to be considered for clinical use.…”