Hematology, Oncology & Immunology
Fever & hypothermia
Fever in critically ill patients requires a systematic approach for evaluation and management. New fever in the ICU can indicate various conditions, including infections, necessitating prompt diagnostic workup and intervention. Febrile neutropenia, common in cancer patients, is a medical emergency requiring immediate assessment, risk stratification, and tailored antimicrobial therapy. Heatstroke, a severe heat-related illness, demands rapid cooling and supportive care to manage organ dysfunction and prevent fatal outcomes.
Hypothermia, particularly accidental hypothermia, poses significant risks and requires immediate recognition and treatment. Effective management involves rewarming techniques and supportive care, with prevention strategies crucial for vulnerable populations. Understanding the pathophysiology and clinical presentation of both hyperthermia and hypothermia is essential for optimizing patient outcomes in critical care settings.
Hyperthermia & pyrexia
Fever in critically ill patients
New fever during ICU treatment
Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU
Naomi P. O’Grady et al., Critical Care Medicine (2023)
What’s inside
This article presents guidelines from the Society of Critical Care Medicine and the Infectious Diseases Society of America on evaluating new fever in adult patients in the intensive care unit (ICU).
Why it’s relevant
New fever in ICU patients can indicate a range of conditions, including infections, which require prompt evaluation and management. These guidelines provide a structured approach to diagnosing and managing fever in this vulnerable population.
Key focus
- Definition and significance of new fever in ICU patients
- Diagnostic approach, including history, physical examination, and laboratory tests
- Role of microbiological testing and imaging in identifying the source of fever
- Management strategies, including empiric antimicrobial therapy and source control
- Considerations for specific patient populations and settings
- Importance of antimicrobial stewardship and infection prevention
Takeaway
The guidelines emphasize a systematic approach to evaluating new fever in ICU patients, highlighting the importance of timely diagnosis and appropriate management to improve patient outcomes and reduce unnecessary antimicrobial use.
Febrile neutropaenia
Febrile neutropaenia
Management of febrile neutropaenia: ESMO Clinical Practice Guidelines
J. Klastersky et al., Annals of Oncology (2016)
What’s inside
This article provides clinical practice guidelines from the European Society for Medical Oncology (ESMO) on the management of febrile neutropenia, a common complication in cancer patients undergoing chemotherapy.
Why it’s relevant
Febrile neutropenia is a medical emergency that requires prompt diagnosis and treatment to prevent severe infections and improve patient outcomes. These guidelines offer evidence-based recommendations for managing this condition.
Key focus
- Definition and risk factors for febrile neutropenia
- Initial assessment and diagnostic workup, including clinical and laboratory evaluations
- Risk stratification to guide management decisions
- Empiric antimicrobial therapy and adjustments based on patient response
- Role of granulocyte colony-stimulating factors (G-CSF) in prevention and treatment
- Considerations for specific patient populations and settings
Takeaway
The guidelines emphasize a structured approach to managing febrile neutropenia, highlighting the importance of early intervention, risk assessment, and tailored antimicrobial therapy to improve patient outcomes.
Heatstroke
Heatstroke
Heatstroke
Yoram Epstein et al., The New England Journal of Medicine (2019)
What’s inside
This article reviews the pathophysiology, diagnosis, and management of heatstroke, a severe heat-related illness characterized by elevated core body temperature and organ dysfunction.
Why it’s relevant
Heatstroke is a life-threatening condition that requires immediate recognition and treatment, particularly in vulnerable populations such as athletes, outdoor workers, and the elderly.
Key focus
- Pathophysiology and risk factors for heatstroke
- Clinical presentation and diagnostic criteria
- Rapid cooling methods and supportive care
- Management of organ dysfunction and complications
- Prevention strategies and public health measures
Takeaway
The article emphasizes the importance of prompt recognition and rapid cooling in managing heatstroke, highlighting the need for preventive measures to reduce morbidity and mortality.
Hypothermia
Accidental hypothermia
Accidental Hypothermia: 2021 Update
Peter Paal et al., International Journal of Environmental Research and Public Health (2022)
What’s inside
This article provides an updated overview of accidental hypothermia, focusing on its pathophysiology, diagnosis, and management strategies.
Why it’s relevant
Accidental hypothermia is a critical condition that can lead to severe complications and death if not promptly recognized and treated, particularly in cold environments or vulnerable populations.
Key focus
- Pathophysiology and classification of accidental hypothermia
- Clinical presentation and diagnostic criteria
- Management strategies, including rewarming techniques and supportive care
- Prevention strategies and public health considerations
- Special considerations for different patient populations
Takeaway
The article emphasizes the importance of early recognition, appropriate rewarming techniques, and preventive measures in managing accidental hypothermia to improve patient outcomes.