Instituto da Criança, Hospital das Clínicas , Faculdade de Medicina , Universidade de São Paulo , São Paulo , SP , Brazil .
Hospital Sírio-Libanês , São Paulo , SP , Brazil .
Einstein (Sao Paulo). 2022 Aug 8;20:eRW6045. doi: 10.31744/einstein_journal/2022RW6045. eCollection 2022.
The objective of this study was to answer several questions related to the assessment and treatment of fever, as well as other controversies that exist during its management in pediatric patients. First, an advisory board with medical experts was conducted to discuss the clinical journey of these patients, considering the main challenges and possible solutions. After this discussion, a non-systematic literature review was performed, between November 2019 and January 2020, to collect the most relevant evidence available in the scientific databases MEDLINE, Lilacs, and SciELO. A narrative review was carried out based on scientific evidence and on extensive experience of experts in clinical practice. The experts developed a set of recommendations and clarifications about the assessment of the severity of fever in pediatrics, the need for treatment and the choice of the most appropriate antipyretic. The most common controversies in the management of fever in pediatric patients were also addressed, such as alternating antipyretics, persistent fever, and dose equivalence. In primary management of pediatric patients, fever should be seen as a relevant symptom that requires treatment with antipyretics in potentially more complex or severe cases, when it causes discomfort to children or is associated with infectious diseases.
本研究的目的是回答与发热评估和治疗相关的几个问题,以及在儿科患者管理过程中存在的其他争议。首先,成立了一个由医学专家组成的顾问委员会,讨论这些患者的临床路径,考虑主要的挑战和可能的解决方案。在这次讨论之后,于 2019 年 11 月至 2020 年 1 月之间进行了一次非系统性文献回顾,以收集科学数据库 MEDLINE、Lilacs 和 SciELO 中可用的最相关证据。根据科学证据和专家在临床实践中的丰富经验,进行了叙述性综述。专家们就儿科发热严重程度的评估、治疗的必要性以及最适当的解热药选择制定了一套建议和澄清。还讨论了儿科患者发热管理中最常见的争议,如交替使用退烧药、持续发热和剂量等效性。在儿科患者的初步管理中,发热应被视为一个相关症状,在潜在更复杂或严重的情况下,需要使用退烧药进行治疗,当发热引起儿童不适或与传染病有关时。