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Related Concept Videos

Increased Body Temperature01:25

Increased Body Temperature

646
A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
646
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Fever Prevention in Patients With Acute Vascular Brain Injury: The INTREPID Randomized Clinical Trial.

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Preventing fever in stroke patients with automated cooling devices reduced fever burden but did not improve functional outcomes. This study highlights the need for further research into fever management strategies after acute vascular brain injury.

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Clinical Trials

Background:

  • Fever is linked to poorer outcomes in stroke patients, but the benefit of fever prevention remains uncertain.
  • Understanding the impact of fever control on functional recovery after acute vascular brain injury is crucial for optimizing patient care.

Purpose of the Study:

  • To assess the feasibility and impact of fever prevention on functional outcomes in critically ill patients with acute vascular brain injury.
  • To compare the effectiveness of an automated surface temperature management device for fever prevention against standard fever treatment.

Main Methods:

  • An open-label randomized clinical trial involving 677 critically ill stroke patients across 43 intensive care units in 7 countries.
  • Patients were randomized to either fever prevention (target 37.0°C) using an automated device or standard care with fever treatment initiated at ≥38.0°C.
  • The primary outcome was daily mean fever burden, with a key secondary outcome being 3-month functional recovery assessed by the modified Rankin Scale.

Main Results:

  • Fever prevention significantly reduced the daily mean fever burden compared to standard care (0.37 vs 0.73 °C-hour, P < .001).
  • No significant difference in functional recovery at 3 months was observed between the fever prevention and standard care groups (OR, 1.09; P = .54).
  • Major adverse events were slightly higher in the fever prevention group (82.2%) versus standard care (75.9%), with similar rates of infections.

Conclusions:

  • Preventive normothermia using automated surface temperature management effectively reduces fever burden in patients with acute vascular brain injury.
  • Despite reducing fever burden, this strategy did not lead to improved functional outcomes at 3 months.
  • The findings suggest that while fever can be controlled, its prevention may not directly translate to better functional recovery in this patient population.