0
Point/Counterpoint Editorials |

Counterpoint: Should Antipyretic Therapy Be Given Routinely to Febrile Patients in Septic Shock? NoFever Should Not Be Treated in Septic Shock

Anne M. Drewry, MD; Richard S. Hotchkiss, MD
Author and Funding Information

From the Department of Anesthesiology (Drs Drewry and Hotchkiss), the Department of Surgery (Dr Hotchkiss), and the Department of Medicine (Dr Hotchkiss), Washington University School of Medicine.

Correspondence to: Anne M. Drewry, MD, Department of Anesthesiology, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110; e-mail: drewrya@anest.wustl.edu


Funding/Support: Dr Drewry receives support from the Washington University Institute of Clinical and Translational Sciences [Grant UL1TR000448] from the National Center for Advancing Translational Sciences. Dr Hotchkiss receives support from the National Institutes of Health [Grants GM44118 and GM55194].

Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Hotchkiss received grant support from MedImmune, LLC; Bristol-Myers Squibb; and Aurigene Discovery Technologies. Dr Drewry has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(4):1098-1101. doi:10.1378/chest.13-0918
Text Size: A A A
Published online

Extract

Fever is a classic symptom of sepsis in critically ill patients and commonly prompts ICU physicians to evaluate for infection. Despite the frequency with which fevers occur in patients in the ICU, there is surprisingly little consistency among intensivists regarding whether fevers should be treated.1 Certainly, there are subsets of critically ill patients—those with neurologic injury or active myocardial ischemia, for example—who are particularly susceptible to the deleterious effects of fever and should undoubtedly receive antipyretic therapy.2 Sepsis, however, is a complex and heterogeneous disease. Although some patients may benefit from the protective effects of fever control, others may not, depending on the severity of their disease and their degree of end-organ dysfunction. Unfortunately, there are few randomized controlled trials to guide clinical practice. Based on the available evidence, though, our opinion is that fever should not routinely be treated in patients with septic shock.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543