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Fever: suppress or let it ride?
Juliet J Ray1, Carl I Schulman1
1DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Journal of Thoracic Disease
|January 22, 2016
Summary
Fever management in critically ill patients is debated. Recent trials suggest allowing fever ("let it ride") may be beneficial, challenging traditional suppression approaches.
Area of Science:
- Critical Care Medicine
- Physiology
- Medical History
Background:
- Fever management has evolved since ancient Greece, yet optimal treatment for critically ill patients remains controversial.
- Two main viewpoints exist: suppressing fever due to metabolic costs or allowing it as a protective response.
- Recent randomized controlled trials are challenging long-standing observational data.
Purpose of the Study:
- To review the evidence and ongoing debate regarding fever treatment in critically ill patients.
- To evaluate the 'let it ride' philosophy versus fever suppression strategies.
Main Methods:
- Review of recent randomized controlled trials and historical observational studies.
- Analysis of the metabolic and physiological implications of fever in stressed hosts.
Main Results:
- Emerging evidence from randomized trials supports the 'let it ride' approach for fever in critical illness.
- This challenges earlier studies advocating for routine fever suppression.
Conclusions:
- The optimal management of fever in critically ill patients is shifting away from automatic suppression.
- Further research is needed to fully understand the benefits and risks of allowing fever to persist.
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