چاپ صفحه |  صفحه نخست سامانه |  چکیده مقاله |  نویسندگان |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| Although physicians usually intervene to treat fever incritically ill patients, the relationship between body dys-thermia (both hypothermia or hyperthermia) and thesepatients’ outcomes are not well understood (1, 2). Feveris practically the most prevalent clinical feature at the on-set of an illness during the hospitalization of patients withSARS-CoV-2 infection (3). Some studies report that fevermanagement in critically-ill patients can increase infec-tion risk without a decrease in mortality (4). For example,a recent meta-analysis on forty-two studies has suggestedthat the mortality rate is lower in septic patients with fever(5). Another study described no significant difference incritically ill patients’ mortality rates between the patientswith more-active fever management and less-active fevermanagement (6). Compatibly, the results of a recently pub-lished meta-analysis show that the use of antipyretic drugsand external cooling is associated with higher risk mortal-ity in septic ICU patients who require mechanical ventila-tion (7).It is difficult to determine whether the excellent out-come of the critically-ill hyperthermic patients is due totheir appropriate ability to respond to the acute phase orthe fever response itself. On the other hand, an ideal targettemperature range optimal for organ function is unclear(8). Moreover, it is still uncertain when and how to attemptto reduce the temperature in a patient with elevated bodytemperature (9).Humans are not adapted to critical illnesses, and in theabsence of contemporary medicine and benefits of inten-sive care, most critically-ill, febrile, and infected patientswith infection and fever would undoubtedly die.Eachphysician should attentively consider the balance betweenthe potential benefits of reducing metabolic rate and thepossible risks of a harmful effect on the host’s defensemechanisms with fever control.The definite impact of the antipyretics’ fever-loweringeffect on critically-ill patients with COVID-19 infection ispresently unknown. Hence, the general approach to thesystematic suppression of fever in these patients is notrecommended, and antipyretics should be administeredbased on each patient’s condition. Although a fever re-sponse, which is in the physiological range with compen-sating changes and settled vital signs, is preferred not tobe treated, the deterioration in vital signs (such as respi-ratory rate and heart rate), or the patients’ general condi-tion and interventions to treat hyperthermia should be im-plemented. Precise, safe, and efficient temperature controlis now doable; however, the most crucial point is to avoidhypothermia in these patients and maintain normother-mia through pharmacologic or non-pharmacologic inter-ventions. |
| نویسنده | نفر چندم مقاله |
|---|---|
| عطا محمودپور | اول |
| سروین سنایی اسکویی | دوم |
| سیدمحمدسالار حسینی | سوم |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| 3jadid.pdf | 1400/01/08 | 74366 | دانلود |
