Effects of Peripheral Cold Application and Antipyretics on Hemodynamic Parameters in Febrile ICU Patients Diagnosed with Hospital-Acquired Infections

Abstract

Background: Accurately assessing hemodynamic parameters plays an important role in preventing complications during and after interventions related to a fever in febrile patients. There are not enough studies related on the effects of peripheral cold application (PCA) and antipyretics (APs) on hemodynamic parameters in febrile patients. Objectives: The aim was to determine the effects of PCA and APs on hemodynamic parameters in febrile ICU patients diagnosed with hospital-acquired infections (HAIs). Methods: In this retrospective study, the archive documents of the 346 adult ICU patients diagnosed with HAIs of a university hospital in Turkey were evalauted. Body temperature (BT), systolic/diastolic blood pressure (SBP/DBP), pulse rate (PR), respiratory rate (RR), and arterial O2Sat (aO2sat) changes one hour before, during, and one hour after application of PCA or APs were evalauted. Results: The incidence of HIAs was 4.16%. A total of 46% of the patients had a bacteremia infection and causative microorganisms in 16.8% were Acinetobacter spp. BT, DBS, PR, and aO2Sat changes one hour before, during, and one hour after PCA were significantly different. In addition, BT, RR, and aO2Sat changes one hour before, during, and one hour after APs were also significantly different (P < 0.05). More decrease in SBP and DBP were observed between during and one hour after APs compare with PCA. Conclusions: BT and hemodynamic parameters, especially SBP and DBP changes, were higher in APs compared with PCA. Knowledge regarding the effects of APs on BT and hemodynamic parameters will be of benefit to the ICU staff in terms of quality of care in febrile patients. The ICU staff should be proactive in ensuring that they have an evidence-based management plan for the prevention of HIAs and management of fever that conforms to the relevant clinical guidelines and integrates multidisciplinary care.