Fever episodes and hemodynamic monitoring of intensive care unit patients

Manifestation of fever is particularly common among intensive care unit (ICU) patients. Parameters of basic hemodynamic monitoring of them may be affected by factors which accompany the increase of temperature, such as the increase of metabolic rate. Aim: To study the effect of fever episodes on heart rate and arterial blood pressure of the general ICU patients. MATERiAL-Method: Medical and nursing actions which mainly affect the hemodynamic state of patients were initially recognized, so that only the effect of fever could be estimated. For the measurement of temperature, two methods were used: tympanic membrane and axillary thermometer. The alterations of hemodynamic parameters were recorded at three different intervals: before the onset of fever, at the highest temperature value and at the return of temperature to normal. Results: Fifty-five patients who manifested 268 fever episodes were included. Heart rate of patients increased significantly during the phase of temperature elevation and decreased significantly during the phase of temperature fall. These alterations were higher when the height of fever exceeded 39 °C, while they were affected by fever etiology as well. Arterial blood pressure of patients showed a significant decrease during the whole fever episode. During the phase of temperature elevation, this decrease was higher when the height of fever exceeded 39 °C. Conclusions: Basic hemodynamic parameters of ICU patients demonstrated significant alterations during the course of fever episodes. However, whether these alterations are a result of temperature elevation itself is difficult to be determined.