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Review
. 2016 Oct 3;20(1):303.
doi: 10.1186/s13054-016-1467-2.

Should we treat pyrexia? And how do we do it?

James F Doyle  1 , Frédérique Schortgen  2
Affiliations
Review

Should we treat pyrexia? And how do we do it?

James F Doyle et al. Crit Care. .

Abstract

The concept of pyrexia as a protective physiological response to aid in host defence has been challenged with the awareness of the severe metabolic stress induced by pyrexia. The host response to pyrexia varies, however, according to the disease profile and severity and, as such, the management of pyrexia should differ; for example, temperature control is safe and effective in septic shock but remains controversial in sepsis. From the reported findings discussed in this review, treating pyrexia appears to be beneficial in septic shock, out of hospital cardiac arrest and acute brain injury.Multiple therapeutic options are available for managing pyrexia, with precise targeted temperature management now possible. Notably, the use of pharmacotherapy versus surface cooling has not been shown to be advantageous. The importance of avoiding hypothermia in any treatment strategy is not to be understated.Whilst a great deal of progress has been made regarding optimal temperature management in recent years, further studies will be needed to determine which patients would benefit the most from control of pyrexia and by which means this should be implemented. This narrative review is part of a series on the pathophysiology and management of pyrexia.

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Figures

Fig. 1
Fig. 1
The main stages of the molecular basis of pyrexia. IL interleukin, PGE2 prostaglandin E2, TNF tumour necrosis factor
Fig. 2
Fig. 2
Suggested impact of pyrexia treatment on outcome according to clinical context. ARDS acute respiratory distress syndrome, CNS central nervous system, OHCA Out-of-hospital cardiac arrest
See this image and copyright information in PMC

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