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Causes of fever in the post op period in gastro surgical cases
1. Release of pyrogens
2. Intraabdominal collections or abscess
3. Blood and platelet infusions
4. Drug fever (e.g., antibiotics, methyldopa, procainamide, phenytoin)
5. Pulmonary complicatons like pneumonia and empyema
Fever increases the immune response of the patient and therefore empirical use of antipyretics is to be avoided
Indications of antipyretic medicines are
a. Patients with coronary artery disease, in whom tachycardia can result in increased myocardial oxygen consumption
b. Patients with intracranial trauma
c. Children with previous febrile or nonfebrile seizures
Postoperative patients
Early Post op fever is defined as that occuring with in 48 hours.
Earlier Atelectasis was defined as a major cause but now new evidence is emerging that this is not so.
a. Fever after an operation is usually benign and self-limited if it occurs within 4 days of surgery.
b. Early fever is likely related to pulmonary atelectasis and responds to pulmonary toilet and incentive spirometry; no other intervention is required unless alternative infectious etiologies are identified.
c. Early wound infections are rare; however, sites should be evaluated for signs of group A streptococcal or clostridial myonecrosis.
Other causes to be ruled out if fever persists
1. Deep Venous thrombosis
2. Pulmonary Embolism
3. Drug Allergy
