tailieunhanh - Báo cáo y học: "Hot times in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Hot times in the intensive care unit. | Abraham Critical Care 2010 14 178 http content 14 4 178 CRITICAL CARE COMMENTARY L__ Hot times in the intensive care unit Edward Abraham See related research by Morris etal. http content 14 3 R125 Abstract Fever is a common occurrence in the intensive care unit and pharmacologic approaches are limited particularly in patients unable to tolerate enteral medications. Although a study by Morris and colleagues in the previous issue of Critical Care suggests that intravenous ibuprofen is safe and effective in critically ill patients the study is small and the drug was given over only a 24-hour period. Additional studies will need to be performed to demonstrate the safety and efficacy of intravenous ibuprofen in critically ill patients. Fever in the context of critical illness is a frequent occurrence and can raise the concern that an infection or other inflammatory process such as pancreatitis is present. In this situation the evaluative process for the cause of fever may result in important modifications in treatment including initiation or alteration in antimicrobial therapy. Fevers can also be a manifestation of drug reactions prompting the discontinuation of suspected agents. However in many cases fever in a critically ill patient is not associated with a treatable etiology and is considered simply a symptom that accompanies the organ dysfunction that brought the patient to the intensive care unit ICU . The optimal approach to fever in the ICU has not been resolved. While reducing fever can improve patient comfort decrease the risk of febrile seizures in the predisposed patient and lower metabolic rate it remains unclear whether antipyretics actually affect patient outcome in clinically meaningful ways. Nevertheless the use of acetaminophen paracetamol ibuprofen and other oral agents remains a common practice in both outpatient and inpatient settings. However there are limited options available for lowering temperature in critically