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Minimizing Complications Related to Fever in the Postoperative Pediatric Oncology Patient

Hematology/Oncology/BMT/Immunology Program at the Hospital for Sick Children in Toronto, Ontario, Canada, ann.chang{at}sickkids.ca

Eleanor Hendershot, MN, RN, ACNP

Hematology/Oncology (Solid Tumor) Clinic at the Hospital for Sick Children in Toronto, Ontario, Canada, Faculty of Nursing at the University of Toronto

Kimberly Colapinto, MN, RN, ACNP

Division of General Surgery at the Hospital for Sick Children in Toronto, Ontario, Canada

Fever is a common postoperative complication that is generally thought to be a benign, self-limiting event. However, for pediatric oncology patients who are often immunocompromised, a postoperative fever may indicate an infection, which can lead to significant complications if not treated promptly. A physical examination, which is an established cost-effective method to rule out infections in the general surgical population, may not be sufficient for oncology patients because clinical symptoms may be atypical or absent in immunocompromised hosts. Although a full septic workup may be unnecessary, additional investigations such as blood cultures may be warranted, and antibiotic therapy should be considered for some or all febrile postoperative cancer patients. No standardized approach to fever management in postoperative oncology patients currently exists, which can present a challenge for those who care for these patients. In the absence of such established practice standards, this article outlines some of the considerations that may be vital in minimizing complications related to fever in the postoperative pediatric oncology patient.

Key Words: postoperative • fever • pediatric oncology

Journal of Pediatric Oncology Nursing, Vol. 23, No. 2, 75-81 (2006)
DOI: 10.1177/1043454205285880


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