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 ≥ 38.3^oC 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.