Fever vs Hyperthermia

Fever:

 • Regulated in the hypothalamic thermoregulatory center

 • "Set point" raised by prostaglandin E2

 • Triggered by pyrogens: Endotoxins, Toxins, Cytokines (IL-1, TNF-a1pha, IL-6, etc.)

 • Antipyretics block prostaglandin E2 production

 • Treatment: Use antipyretics to block prostaglandin E2 production and decrease the elevated hypothalamic set-point

Hyperthermia:

 • Not regulated by hypothalamic set point

 • Body temperature rises uncontrollably

 • Can be rapidly fatal

 • Causes: Drugs: Ecstasy, atropine; Heat stroke; Malignant hyperthermia; Neuroleptic malignant syndrome; Serotonin syndrome

 • Treatment: 

   - Identify underlying cause

   - Antipyretics are of no use

   - Cool damp sponge bath (no submersion) to allow for evaporative heat loss

   - Cool fluids peripherally

   - Cooling blankets can cause harm as they lead to peripheral vasoconstriction, preventing heat loss from the skin



BWH Medicine Chiefs @BrighamChiefs



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