Description
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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