Golding Robert, Taylor Daniel, Gardner Hannah, Wilkinson Jonathan N
Northampton General Hospital, Cliftonville, Northampton, UK.
J Intensive Care Soc. 2016 May;17(2):154-159. doi: 10.1177/1751143715608642. Epub 2015 Oct 1.
Should we aim to intervene and control fever in the critically ill patient? The answer is not straightforward and there is certainly no universal agreement on the subject. This article aims to discuss whether we should over-ride nature and disallow it to take it's course, particularly where it appears that this evolutionary response to invading pathogens is actually becoming harmful to the patient. Also discussed here are the physiology of temperature control and the scope of our current understanding of the impact of fever in patients manifesting systemic inflammatory response syndrome (SIRS) and sepsis in ICU, the possible interventions to combat fever (both physical and pharmacological) and the evidence for anti-pyretic drug therapy. The final section examines the potential role of targeted temperature management in the management of sepsis / SIRS in the critically ill.
我们是否应该致力于干预并控制重症患者的发热？答案并非简单直接，而且在这个问题上肯定没有普遍共识。本文旨在探讨我们是否应该违背自然规律，不让其顺其自然发展，特别是当这种对入侵病原体的进化反应似乎实际上对患者有害时。这里还讨论了体温调节的生理学、我们目前对重症监护病房中出现全身炎症反应综合征（SIRS）和脓毒症的患者发热影响的理解范围、对抗发热的可能干预措施（包括物理和药物方面）以及退热药物治疗的证据。最后一部分探讨了目标温度管理在重症患者脓毒症/SIRS管理中的潜在作用。
