严重的戒断性出汗和发热导致低血容量性休克：病例报告。
Severe diaphoresis and fever during alcohol withdrawal cause hypovolemic shock: case report.
机构信息
Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan.
出版信息
BMC Psychiatry. 2021 Aug 4;21(1):387. doi: 10.1186/s12888-021-03393-x.
BACKGROUND
Several fatal medical complications have been associated with alcohol withdrawal, such as seizure, cardiac arrhythmia, and takotsubo cardiomyopathy. However, there have been no reports on hypovolemic shock during alcohol withdrawal, although two physical signs of alcohol withdrawal, i.e., diaphoresis and fever, can lead to hypovolemia and its medical consequences.
CASE PRESENTATION
We describe a patient with alcohol use disorder who exhibited hypovolemic shock and its associated acute renal failure during alcohol withdrawal with severe diaphoresis and fever even though he had consumed almost the full amount of food he was offered. Given his excessive diaphoresis and fever that were related to alcohol withdrawal, his water intake was insufficient. Infusion with extracellular fluid resolved all these medical issues.
CONCLUSIONS
The increased adrenergic activity associated with alcohol withdrawal might substantially increase a patient's water-intake requirement through diaphoresis and fever and may cause severe hypovolemia and its associated medical complications.
背景
酒精戒断可能引发多种严重的医疗并发症，如癫痫发作、心律失常和心尖球形综合征。然而，尽管酒精戒断的两个体征，即出汗和发热，可能导致血容量不足及其医疗后果，但尚未有关于酒精戒断期间出现低血容量性休克的报告。
病例介绍
我们描述了一位患有酒精使用障碍的患者，他在酒精戒断期间出现了低血容量性休克及其相关的急性肾衰竭，尽管他已经摄入了几乎全部提供的食物，但仍出现严重的出汗和发热。鉴于他的过度出汗和与酒精戒断相关的发热，他的水摄入量不足。通过输注细胞外液解决了所有这些医疗问题。
结论
酒精戒断引起的肾上腺素能活性增加可能会通过出汗和发热极大地增加患者的水摄入需求，并可能导致严重的血容量不足及其相关的医疗并发症。
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