SCCM Resource Library-Evaluation of New Fever in Critically Ill Adult Patients

Video Transcription

Video Summary

Naomi O'Grady presents updated 2023 guidelines from SCCM and IDSA for evaluating new fever in adult ICU patients, contrasting them with the 2008 guidelines through the use of GRADE methodology. These updates include 12 recommendations and nine best practice statements, underscoring that not all febrile episodes demand extensive investigation. A thorough history and physical exam help determine necessary testing. Key points include accurate temperature measurement preferences, although not recommending routine use of central thermometers due to low evidence quality. Treating fever with antipyretics like ibuprofen shows no mortality benefit, though may be necessary in specific situations, such as preventing seizures. Imaging like chest X-rays should be guided by history and physical exam. Blood cultures should ideally include catheter samples to identify infection sources, and urine cultures warrant meticulous collection methods. Viral testing is crucial in patients with pneumonia or respiratory symptoms, as certain viruses have treatments. Biomarkers like procalcitonin can guide empiric antibiotic use reduction, but shouldn't solely determine infection presence. The presentation concludes by highlighting advancements needed in testing methods, temperature measurement, and diagnostic imaging.

Asset Caption

One-Hour Concurrent Session | New SCCM Guidelines: Liver Failure, New Fever, and Corticosteroids

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

fever evaluation

ICU guidelines

antipyretics

biomarkers

diagnostic imaging

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