Approach to the Febrile Patient in the Intensive Care Unit

Fever occurs in approximately one-third of all medical patients during their hospital stay and in more than 90% of critically ill patients with severe sepsis [1]. According to the Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA), a temperature above 38.3°C (101°F) should be considered as fever necessitating a clinical assessment. The mean body temperature in healthy individuals is 36.8°C (98.2 °F), with a range of 35.6°C (96°F) to 38.2°C (100.8 °F) and a slight diurnal/circadian variation of between 0.5 and 1.0°C [2, 3]. Patients with elevated temperature in the ICU are in a closed monitoring system undergoing accurate and reproducible measurements using a variety of methods (instruments and techniques) at different body sites (Table 1.1) [4].