Postoperative fever is where a Pt develops a fever after a surgery. It is a common condition, but is challenging, because it can be a hallmark of a serious underlying condition.
Pathophysiology
If postop fever occurs in the first 24 hours after a major surgery, it is most often a result of natural and non-infectious inflammatory response to tissue injury sustained in the procedure itself → requires no intervention
Cause
5 W's, including:
Wind, which occurs 1-2 days after surgery. It includes:
Lungs, i.e. pneumonia, and aspiration
Water, which occurs 3-5 days after surgery. It includes:
UTI
Related to indwelling catheter (during surgery or currently, i.e. Foley catheter)
Walking (or Veins, which sounds like "Weins", which occurs 4-6 adys after surgery. it includes:
DVT
PE (pulmonary embolism)
Wound, which occurs 5-7 days after surgery. It includes:
Surgical site infection, e.g. the uterus
Wonder drugs, which occurs 7+ days after surgery. It includes:
Drug fever
Infections related to IV lines or reaction to blood products
Patient information
What causes fever after an operation?
We summarize it in the 5 W's. Wind. Water. Walking. Wound. Wonder drugs. Wind is pneumonia and aspiration. Water is UTI and catheters. Walking is DVT and PE. Wound is surgical site infection. Wonder drugs are fevers due to drugs, or infections due to IV lines or blood products.
Ix
ABC's, examining:
Ob's
Blood clots
Review of systems
Urine culture
Blood culture
Wound culture
Imaging
Mx
IV antibiotics → prophylactic
Anticoagulants (e.g. clexane) → thrombotic risk
Epidemiology
33% will develop fever after a surgery depending on the type of surgery, but only a small percentage are due to an infection
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