WhaSook Seo is a professor at Inha University Department of Nursing, Incheon, Republic of Korea.
Crit Care Nurse. 2023 Feb 1;43(1):12-19. doi: 10.4037/ccn2023610.
Paroxysmal sympathetic hyperactivity may occur in patients with acute brain injury and is associated with physical disability, poor clinical outcomes, prolonged hospitalization, and higher health care costs.
To comprehensively review current literature and provide information about paroxysmal sympathetic hyperactivity for nurses.
An integrative literature review was conducted according to Whittemore and Knafl's method. The search was conducted from October 2020 through January 2021. The main targets of the literature search were definition, incidence rate, causes, clinical characteristics, pathophysiology, diagnosis, and treatment of paroxysmal sympathetic hyperactivity in pediatric and adult patients. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
The most characteristic clinical features of paroxysmal sympathetic hyperactivity are hypertension, tachycardia, tachypnea, hyperthermia, diaphoresis, and abnormal motor posturing. Reported incidence rates of paroxysmal sympathetic hyperactivity in patients with brain injury range from 8% to 33%. Various diagnostic criteria have been proposed; most are based on clinical symptoms. Ruling out other causes of the signs and symptoms of paroxysmal sympathetic hyperactivity is important because the signs and symptoms are nonspecific. The major goals of paroxysmal sympathetic hyperactivity management are avoidance of stimuli that may trigger a paroxysmal episode, inhibition of sympathetic overactivity, and prevention of damage to other organs.
Critical care nurses should be aware of the signs and symptoms of paroxysmal sympathetic hyperactivity in patients with acute brain injury. Early identification is important to ensure timely treatment for patients with paroxysmal sympathetic hyperactivity.
阵发性交感神经过度兴奋可能发生于急性脑损伤患者，与身体残疾、临床预后不良、住院时间延长和医疗保健费用增加有关。
全面综述现有文献，为护士提供阵发性交感神经过度兴奋相关信息。
按照 Whittemore 和 Knafl 的方法进行综合文献回顾。检索时间为 2020 年 10 月至 2021 年 1 月。文献检索的主要目标是定义、发生率、原因、临床特征、病理生理学、诊断和治疗儿童和成人患者的阵发性交感神经过度兴奋。结果按照系统评价和荟萃分析的 Preferred Reporting Items 报告。
阵发性交感神经过度兴奋最具特征性的临床特征是高血压、心动过速、呼吸急促、发热、出汗和异常运动姿势。报道的脑损伤患者阵发性交感神经过度兴奋发生率为 8%至 33%。已提出多种诊断标准；大多数基于临床症状。排除阵发性交感神经过度兴奋的体征和症状的其他原因很重要，因为这些体征和症状是非特异性的。阵发性交感神经过度兴奋管理的主要目标是避免可能引发阵发性发作的刺激、抑制交感神经过度兴奋和预防对其他器官的损害。
重症监护护士应了解急性脑损伤患者阵发性交感神经过度兴奋的体征和症状。早期识别对确保阵发性交感神经过度兴奋患者及时治疗很重要。
