Fever Clinical Trial
Official title:
An Observational Study of the Epidemiology of Fever Due to Infection in Critically Ill Children Following an Unplanned Admission to a Paediatric Intensive Care Unit
To inform the feasibility of conducting a study to test different temperature thresholds at which clinicians deliver interventions to reduce fever (i.e. antipyretic interventions) in critically ill children with fever due to infection.
Fever (high temperature) is a normal bodily response to an infection, which has shown to
have a beneficial effect in humans with chickenpox, malaria and rhinovirus infections. In
children it has been recommended by the National Institute for Health and Care Excellence
not to cool down the child using drugs or physical methods such as a cooling mat, with the
sole aim to reducing the child's temperature. However, this recommendation is not aimed at
the management of critically ill children, to which there is uncertainty around use of
cooling interventions when considering the advantages of a fever in defending the body
against viruses and bacteria during critical illness, and weighing that up with the possible
negative physiological consequences of a high fever e.g. increased metabolic rate.
Observational studies show that the treatment of fever in critically ill children is
inconsistent. There is a lack of robust data to guide antipyretic intervention, with
clinicians usually starting fever management at around 37.5°C. Evidence is emerging that
fever may be beneficial in critically ill adults. Due to the physiological differences
between adults and children there is an important need to evaluate whether a different
approach to fever management in critically ill children may also be beneficial.
Prior to conducting a large, expensive, randomised clinical trial (RCT) to evaluate whether
a higher temperature threshold in starting treatments to cool down the child would be
beneficial, we are conducting three studies to know if it is possible for us to test key
outcome measures as a result of testing different temperatures thresholds for antipyretic
management.
The Fever Observational Study is one of these studies, with the aim of identifying: the
potential population that would be eligible for the proposed definitive trial, current
temperature threshold(s) for fever management, and to describe the characteristics of
outcome measures with the intention of deciding on a main measure to see which treatment
method was more successful.
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