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Fever and ICH
- Fever is a common event in patients with intracerebral hemorrhage (ICH) and is associated with an increased length of ICU stay, cognitive impairment, and poor outcome.
- While much of the management (and controversies) of the patient with ICH focuses on blood pressure control and reversal of oral anticoagulants or antiplatelet agents, don't forget about temperature control.
- Aggressively treat temperatures ≥ 38.3oC in patients with an ICH.
- Importantly, there is currently insufficient evidence to support a superior method of fever control (antipyretics or surface/intravascular cooling devices).
References
Flower O, Smith M. The acute management of intracerebral hemorrhage. Curr Opin Crit Care 2011; 17:106-14.