Management Of Fever In Patients Research Articles

Fever Management in Patients With Brain Injury

Elevated temperature in patients with brain injury has been linked to increased hospital and intensive care unit lengths of stay, increased morbidity, greater disability, and higher mortality. The prevailing medical opinion is that maintaining normothermia in patients with acute brain injury is beneficial. However, little evidence exists to support this recommendation. Nurses are responsible for diagnosing and treating fever, but evidence-based guidelines that would govern fever management for these patients do not exist. This article discusses what evidence is available to support the management of fever in patients with brain injury and in what areas evidence is lacking.

Fever Management in Patients With Brain Injury

Elevated temperature in patients with brain injury has been linked to increased hospital and intensive care unit lengths of stay, increased morbidity, greater disability, and higher mortality. The prevailing medical opinion is that maintaining normothermia in patients with acute brain injury is beneficial. However, little evidence exists to support this recommendation. Nurses are responsible for diagnosing and treating fever, but evidence-based guidelines that would govern fever management for these patients do not exist. This article discusses what evidence is available to support the management of fever in patients with brain injury and in what areas evidence is lacking.

A Prospective, Open-Label Noncomparative Study with Piperacillin-Tazobactam Monotherapy as Management of Fever in Patients with Acute Leukemia

We evaluated the efficacy of piperacillin-tazobactam monotherapy as empiric therapy of fever in acute leukemia patients in a total of 80 consecutive febrile episodes. The overall success rate was 75% with success without modification in 34% (afebrile at 72 h) and an overall death rate of 10%. No significant differences were seen in correlation between clinical outcome and phases of underlying disease. The success without modification was higher in patients with fever of unknown origin (FUO) than in those with documented infections (47% and 25% respectively). There were no significant differences in correlations between clinical response and degree of neutropenia. Our study suggests that empirical first-line monotherapy with piperacillin-tazobactam may be a reasonable option in patients with acute leukaemia, although in documented infections the response is frequently inadequate.

8097 POSTER Advanced nursing guideline for fever management in patients with solid tumours participating in phase I research

8097 POSTER Advanced nursing guideline for fever management in patients with solid tumours participating in phase I research

Evidence-based approach to management of fever in patients with end-stage dementia.

Alzheimer's dementia and related dementias are incurable illnesses for which curative treatment currently does not exist, and the efficacy of remittive treatment is extremely limited. Persons with advanced dementia commonly develop fever and are at high risk for death. We preformed a systematic review of outcome following fever in patients with advanced Alzheimer's dementia and developed evidence-based recommendations for the treatment of fever in this population of patients. We use a case example to illustrate our discussion.

Which children with fever and neutropenia can be safely treated as outpatients?

Which children with fever and neutropenia can be safely treated as outpatients?

Management of Fever in Patients with Cancer and Treatment-Induced Neutropenia

The importance of neutropenia in the risk of serious infection in patients with cancer who are receiving cytotoxic chemotherapy was first recognized nearly 30 years ago1. Since then, considerable progress has been made in the management of fever and neutropenia in both adults and children, resulting in improved survival rates not only for these patients but also for other immunosuppressed patients, including those undergoing organ or bone marrow transplantation and those with bone marrow failure or human immunodeficiency virus (HIV) infection2,3. Some of the current principles for the management of fever in patients with neutropenia are outlined . . .

Management of fever in patients with central vein catheters.

We have evaluated a standardized prospective system for managing episodes of fever in pediatric patients with indwelling central vein catheters being used primarily for delivery of parenteral nutrients. Over an 18-month period 72 such patients, accounting for 4347 "catheter days," were followed. Thirty-two patients experienced a total of 88 episodes of fever. An infection unrelated to the presence of the catheter (e.g. otitis media, pneumonia, urinary tract infection) was found to be the cause of fever in 27 episodes (31.7%); in all the infection responded to appropriate antibiotic therapy. Ten of the episodes of fever (11.4%) lasted for less than 2 hours and were not evaluated further. Two episodes occurred in patients who no longer required the catheter; these resolved with elective catheter removal. The cause of the remaining 49 episodes of fever was assumed to be catheter-related sepsis; these were treated empirically with an intravenous antibiotic regimen of vancomycin (40 mg/kg/day) and gentamicin (7.5 mg/kg/day). In 16 of these cases blood cultures were negative and the antibiotic regimen was either stopped or continued for other indications. The remaining 33 episodes of fever were associated with positive blood cultures, i.e. documented episodes of catheter-related sepsis. In 10 of these the catheters were removed. The remaining 23 episodes of catheter-related sepsis were treated for 14 days with antibiotics given through the central vein catheter. In 5 of these episodes blood cultures remained positive after 48 hours of specific antibiotic therapy at which time the catheter was removed.(ABSTRACT TRUNCATED AT 250 WORDS)