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Treat Nobody’s Fever? Podcast #38


Fever, maybe a good thing?

Paul Young and colleagues recently published a meta-analysis that was designed to answer the question – does any group of patients benefit from fever control? The research question was: Since fever is physiologically costly, do patients “with limited physiologic reserves” benefit from reducing fever? The short answer, even for these fragile patients, is No! Listen as Joe Alcock reviews this paper in the broader context of evolution and fever in this short podcast.

From Young et al. 2019:

“Our findings do not support the hypothesis that more active fever management increases survival compared with less active fever management overall or in patients with limited physiological reserves.”


Here is the link: Young et al. Fever control in critically ill adults. An individual patient data meta-analysis of randomised controlled trials

Here is Paul Young giving an excellent talk on fever at SMACC Gold  (Skip to minute 3:48 for the beginning of the talk):

Listen to Paul Young give an evolution-minded lecture on the function of fever and the HEAT trial

Here is the paper discussing fever in neutropenic patients:

A randomized controlled feasibility trial of paracetamol during febrile neutropenia in hemato-oncology patients

Check out previous links on fever – Part 1, Part 2, and New Normals. How many studies do we need to do before we conclude that fever is a beneficial adaptation to infection and does not require treatment? What do you think?


Categories: Uncategorized

Joe Alcock

Emergency Physician, Educator, Researcher, interested in the microbiome, evolution, and medicine

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