HYPERTHERMIC SYNDROME

HYPERTHERMIC SYNDROME - increase in body temperature up to 40 ° C and higher, accompanied by impaired function of the central nervous system, cardiovascular system and metabolism of varying severity. The syndrome develops on the background of various diseases (infectious, infectious-allergic, allergic), with malignant tumors, hemorrhage in the hypothalamus, poisoning, during intensive therapy, after injury, surgical interventions. Hyperthermia syndrome occurs more often and is more severe in children.

In most cases, the temperature increase, which is more often observed in infectious diseases, is protective, benign in nature and does not pose a danger to the patient. However, some children may have febrile seizures . The most dangerous option is malignant hyperthermia, which can be fatal. Malignant hyperthermia is rare, is a complication of combined general anesthesia. It is characterized by a rapid rise in temperature to 42 ° C and higher, increasing tachycardia, cardiac arrhythmia, muscle rigidity, arterial hypertension, myoglobinuria, coagulopathy.

In each case of hyperthermic syndrome, it is necessary to find out the reasons for the increase in temperature in order to prescribe adequate treatment. The grounds for antipyretic therapy in children are: body temperature above 38.5 ° C, history of febrile convulsions , CNS damage, age up to 3 months, in which children are prone to develop hyperthermic convulsions.

When using antipyretic drugs orally, preference is given to acetylsalicylic acid (if there is no hemorrhagic syndrome and adverse reactions in the history), which is prescribed at 10-30 mg / kg per day.

In the absence of effect or inability to give the drug, intramuscularly separately administered 50% solution of dipyrone (0.1 ml per year of life), 4% solution of amidopirina (0.1 ml per 1 kg of weight). The simultaneous use of analgin and amidopirina enhances and prolongs the antipyretic effect. When excited intramuscularly, a 2.5% solution of aminazine with a 2.5% solution of pipolfen or a 1% solution of dimedrol (0.1 ml per year of life) is injected, which have a calming effect.

When conducting antipyretic therapy, the child should be easy to wear, give him as much liquid as possible, and in the absence of stool, make a cleansing enema. Only after 1 hour after taking antipyretics, if necessary, you can apply physical methods of cooling: open the child, turn on the fan, rub his body with warm water or alcohol. You can not use cold water or ice, as a rapid decrease in body temperature can cause spasm of blood vessels and a decrease in heat transfer, which causes an even higher temperature.

In case of malignant hyperthermia, the cessation of anesthesia and surgery is necessary. Hyperventilation is carried out with pure oxygen, sodium bicarbonate, analgin, amidopyrine , antihistamines, antipsychotics, ganglioblokatory, glucocorticoids are administered. Physical cooling methods are also used: