Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey.
Details
State: Public
Version: Final published version
Serval ID
serval:BIB_FBF5F4D4E761
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey.
Journal
Critical care (London, England)
Working group(s)
EUROBACT Investigators
Contributor(s)
Lipman J., Leditschke A., Rodgers H., Milliss D., Gottlieb T., Baker S., Roberts B., Krafft P., Bernreiter S., Depuydt P., Jamaer P., Lebbinck H., De Carvalho F.B., Pereira J., Yehia A.C., Machado F.C., Carneiro A.L., Fagundes A., Rodriguez F., Soares M., Salluh J., Beranger R., Lugarinho M., Carvalho A., Reis L., de Lima C., Piras C., Caser E., Falcão J., Laupland K.B., Laupland K.B., Laupland K.B., Laupland K.B., Zhang Z., Ma X., Wan X.Y., Zhang J.Z., Qian K.J., Xia L., Yang C., Lijing D., Duan M., Zhanhong T., Yiping P., Yongqiang W., Ning L., Li-Xin Z., Jin-Quan L., Wan X.Y., Gornik I., Degoricija V., Kouatchet A., Plantefeve G., Pajot O., Kallel H., Thierry L., Pierre K., Petitpas D., Lessire H., Brun-Buisson C., Pham T., Annane D., Maxime V., Herault M.C., Merceron S., Kipnis E., Boyer-Besseyre M., Tavernier B., Faivre S., Francois V., Ercole R.L., Willems V., Klouche K., Delabre J.P., Julien C., Brigitte G., Gibot S., Mégarbane B., Seguin P., Launoy A., Vincent T., Jamali S., Calvino S., Tabah A., Durand M., Rossi-Blancher M., Debrumetz A., Azoulay E., Charpentier J., Chiche J.D., Garrouste-Orgeas M., Misset B., Marx G., Krueger W.A., Felbinger T., Heininger A., Voigt I., Schroeder T., Pneumatikos I., Theodorou V., Koulenti D., Armaganidis A., Myrianthefs P., Gavala A., Nikolaou C., Kounougeri K., Routsi C., Liapikou A., Nathanail C., Tsakas P., Karabinis A., Tsakalakis C., Mandragos K., Katsenos C., Anthopoulos G., Choutas G., Koutsikou A., Nikolaidou I., Bekos V., Spring A., Paskalis H., Psallida V., Ioakeimidou A., Lahana A., Plantza P., Nodarou A., Koutsoukou A., Kyriakopoulou M., Michalia M., Clouva-Molyvdas P., Sfyras D., Georgiadis C., Polakis P., Papanikolaou S., Christopoulos C., Vrettou E., Arvaniti K., Matamis D., Paraforou T., Spiropoulou K., Georgopoulos D., Klimathianaki M., Nakos G., Koulouras V., Komnos A., Chovas A., Prekates A., Magira E., Giannakoy M., Gkeka E., Antoniadou E., Antypa E., Gritsi-Gerogianni N., Kydona C., Zakynthinos E., Tzovaras N., Csomos A., Gábor C., Mikos B., Velkey G., Vitális E., Kovács N.Á., Bogar L., Kiss T., Eva Z., Mangani V., Tulli G., Stefania G., Chiara R., Antonelli M., Montini L., Rocco M., Citterio G., Fujitani S., Hosokawa K., Said M., Boubaker C., Schultz M., Van Der Veen A., Aardema H., Bergmans D., Schoemakers R., Wesselink R., Oostdijk E.A., Bonten M.J., Dragan I., Kostyrka W., Tamowicz B., Mikstacki A., Smuszkiewicz P., Nadolski J., It O.I., Choma R., Koscielniak W., Pietraszek P., Maul E., Bártolo A., Martins S., Miranda I., Oliveira M., França C., Tornada A., Telo L., Ferreira L., Cardoso T., Santos L., Ferreira A., Pereira J.M., Dias C., Dias M.C., Marques A.J., Castelões P., Batranovic U., Gavrilovic S., Filipescu D., Alvarez-Lerma F., Gracia M.P., Armestar-Rodriguez F., Mesalles-Sanjuán E., De Arbina N.L., Sirvent J., Garro P., Cañones J.R., Blanco A., Marqués L., Insausti J., Martija I., Valles J., Ferrer R., Ubeda A., Lucena F., Cuevas M.G., Zaragoza R., Sancho S., Laube M., Rothen M., Eggimann P., Pagani J.L., Ayed S., Ouanes I., Abroug F., Özcengiz D., Yağar S., Ünver S., Tunçel Y.I., Buyukkocak U., Aykac E., Coşar A., Yilmaz H.O., Pirat A., Zeyneloglu P., Girgin N.K., Akalın H., Sungurtekin H., Serin S., Akinci I., Adanir T., Sencan A., Dilek A., Kati I., Goktas U., El Houfi A.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
10/12/2013
Volume
17
Number
6
Pages
R289
Language
english
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Publication Status: epublish
Abstract
Although fever and hypothermia are common abnormal physical signs observed in patients admitted to intensive care units (ICU), little data exist on their optimal management. The objective of this study was to describe contemporary practices and determinants of management of temperature abnormalities among patients admitted to ICUs.
Site leaders of the multi-national EUROBACT study were surveyed regarding diagnosis and management of temperature abnormalities among patients admitted to their ICUs.
Of the 162 ICUs originally included in EUROBACT, responses were received from 139 (86%) centers in 23 countries in Europe (117), South America (8), Asia (5), North America (4), Australia (3) and Africa (2). A total of 117 (84%) respondents reported use of a specific temperature threshold in their ICU to define fever. A total of 14 different discrete levels were reported with a median of 38.2°C (inter-quartile range, IQR, 38.0°C to 38.5°C). The use of thermometers was protocolized in 91 (65%) ICUs and a wide range of methods were reportedly used, with axillary, tympanic and urinary bladder sites as the most common as primary modalities. Only 31 (22%) of respondents indicated that there was a formal written protocol for temperature control among febrile patients in their ICUs. In most or all cases practice was to control temperature, to use acetaminophen, and to perform a full septic workup in febrile patients and that this was usually directed by physician order. While reported practice was to treat nearly all patients with neurological impairment and most patients with acute coronary syndromes and infections, severe sepsis and septic shock, this was not the case for most patients with liver failure and fever.
A wide range of definitions and management practices were reported regarding temperature abnormalities in the critically ill. Documenting temperature abnormality management practices, including variability in clinical care, is important to inform planning of future studies designed to optimize infection and temperature management strategies in the critically ill.
Site leaders of the multi-national EUROBACT study were surveyed regarding diagnosis and management of temperature abnormalities among patients admitted to their ICUs.
Of the 162 ICUs originally included in EUROBACT, responses were received from 139 (86%) centers in 23 countries in Europe (117), South America (8), Asia (5), North America (4), Australia (3) and Africa (2). A total of 117 (84%) respondents reported use of a specific temperature threshold in their ICU to define fever. A total of 14 different discrete levels were reported with a median of 38.2°C (inter-quartile range, IQR, 38.0°C to 38.5°C). The use of thermometers was protocolized in 91 (65%) ICUs and a wide range of methods were reportedly used, with axillary, tympanic and urinary bladder sites as the most common as primary modalities. Only 31 (22%) of respondents indicated that there was a formal written protocol for temperature control among febrile patients in their ICUs. In most or all cases practice was to control temperature, to use acetaminophen, and to perform a full septic workup in febrile patients and that this was usually directed by physician order. While reported practice was to treat nearly all patients with neurological impairment and most patients with acute coronary syndromes and infections, severe sepsis and septic shock, this was not the case for most patients with liver failure and fever.
A wide range of definitions and management practices were reported regarding temperature abnormalities in the critically ill. Documenting temperature abnormality management practices, including variability in clinical care, is important to inform planning of future studies designed to optimize infection and temperature management strategies in the critically ill.
Keywords
Acetaminophen/therapeutic use, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Antipyretics/therapeutic use, Bacteremia/diagnosis, Clinical Protocols, Fever/diagnosis, Fever/etiology, Fever/therapy, Humans, Hypothermia/diagnosis, Hypothermia/etiology, Hypothermia/therapy, Hypothermia, Induced, Intensive Care Units, Thermometers
Pubmed
Open Access
Yes
Create date
16/12/2016 10:35
Last modification date
20/08/2019 16:27
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