In a review published in
in 2021 (Guoxinba), some scholars have comprehensively sorted out national and international guidelines on the treatment of children's fevers published worldwide, and found a total of 74 guidelines, including 3 international guidelines and 49 national guidelines. There are 6 countries following another national or international guidelines. Therefore, these guidelines represent official recommendations for fever management in children in at least 55 countries around the world.
By combing these guidelines, the authors found that the guides of most countries recommend that no matter how much temperature the body temperature is, do not treat the fever itself.
That is to say, no matter how much temperature it is, should not reduce the fever simply to reduce the fever .
Specifically, among the 74 guides, it is recommended to reduce fever simply for the purpose of reducing fever, and only 22 parts were given the threshold for the reduction of fever, and 44 parts were recommended not to reduce fever simply for the reduction of fever, and 8 parts did not give clear suggestions in this regard.
means that only 33% of the people recommended to reduce the fever simply for the purpose of reducing the fever. Why does
reduce the fever?
More detailed analysis shows that 22 (33%) of the guidelines suggest that fever should be reduced when the fever reaches a certain temperature; among the 44 guidelines that do not recommend that fever be reduced simply for the sake of fever reduction, 32 (49%) said that fever treatment is to relieve discomfort, and 12 (18) said that it is to relieve discomfort + reduce body temperature.
How much does the body temperature reach to start to reduce the fever treatment?
In the guide to giving the antipyretic threshold, the opinions on the body temperature of starting the antipyretic treatment are not consistent, with the specific values ranging from 37.5℃ to 40.5℃.
As for the specific temperature threshold, it is recommended that the treatment should start cooling if it exceeds 38.5℃ or 39℃, followed by 38℃. Some guidelines recommend that fever should be reduced if it exceeds 37.5℃. Similarly, there are other guidelines that only when the body temperature exceeds 40.5℃ can the treatment be required. What is the basis for
to reduce fever or not?
Interestingly, no research evidence is given, whether it is advocating the fever or not, is "following the feeling" .
said to relieve discomfort, as well as relieve discomfort + reduce body temperature. The statement given is that it is based on physiological mechanism reasoning and clinical experience;
gives almost no reason to give a fever-reducing body temperature threshold.
In addition to a small clinical trial published in 2019, a severely ill child with fever living in a pediatric ICU was compared with the clinical consequences of using 37.5°C and 39.5°C as the threshold for fever-reducing .
results show that no matter which threshold is used to start the fever reduction, it has no effect on the final clinical consequences.
does not reduce fever, and does not affect the prognosis of severe diseases
In addition to the above study of severe children living in ICU in the UK, a 2018 study review involving severe adult patients living in the ICU also found that regardless of whether the fever is reduced or not, the final all-cause mortality rate, the time of staying in the ICU and the total hospital stay have nothing to do with the time of stay in the ICU and the total hospital stay.
In other words, the final consequences of patients with fever or not are the same.
It can be seen that for patients with fever, the final consequences of whether or not the fever is reduced are the same; fever reduction treatment is just to try to make patients with fever feel more comfortable.
