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Fever during pediatric intensive care unit admission is independently associated with increased morbidity

Maartje S Gordijn1, Frans B Plötz, Martin C J Kneyber

  • 1Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands.

Journal of Intensive Care Medicine
|August 8, 2009
PubMed

Insights

Fever in critically ill children is common in the pediatric intensive care unit (PICU). Late-onset fever or new fever episodes after 48 hours are linked to nosocomial infections and longer hospital stays.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease epidemiology
  • Clinical outcomes research

Background:

  • Fever is a common occurrence in critically ill children admitted to the pediatric intensive care unit (PICU).
  • Understanding the timing, causes, and impact of fever is crucial for optimizing patient care and outcomes.

Purpose of the Study:

  • To determine the incidence and causes of fever during pediatric intensive care unit (PICU) admission.
  • To investigate the association between fever and clinical outcomes, including duration of mechanical ventilation and PICU length of stay.

Main Methods:

  • Retrospective, observational, single-center study of 202 pediatric patients (0-18 years) admitted between January and June 2004.
  • Fever defined as core temperature ≥38.3°C. Data collected included demographics, clinical information, and outcomes.
  • Statistical analysis employed nonparametric univariate and multivariate Cox's regression models.

Main Results:

  • Fever occurred in 40.6% of patients. Early-onset fever (within 48 hours) was associated with the primary diagnosis.
  • Late-onset fever (after 48 hours) or new febrile episodes were frequently linked to nosocomial infections (≥50% proven).
  • Fever developing after 48 hours or recurrent fever episodes were independently associated with prolonged mechanical ventilation and PICU stay.

Conclusions:

  • Fever is a frequent complication in critically ill children within the PICU.
  • Nosocomial infections are a primary driver of late-onset or recurrent fever in this population.
  • These febrile episodes significantly correlate with extended mechanical ventilation requirements and longer PICU admissions.
Abstract

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