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- 저자 : Keshav Goyal (검색결과 2 건)
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Central fever: a challenging clinical entity in neurocritical care
Keshav Goyal,Neha Garg,Parmod Bithal 대한신경집중치료학회 2020 대한신경집중치료학회지 Vol.13 No.1
Fever is probably the most frequent symptom observed in neurointensive care by healthcare providers. It is seen in almost 70% of neurocritically ill patients. Fever of central origin was first described in the journal Brain by Erickson in 1939. A significant number of patients develop this fever due to a noninfectious cause, but are often treated as having an infectious fever. Unjustified use of antibiotics adds to the increased cost of treatment and the emergence of resistant strains, contributing to additional morbidity. Since fever has a detrimental impact on the recovery of the acutely injured brain and contributes to an increased stay in the neurointensive care unit (NICU), timely and accurate diagnosis of the cause of fever in the NICU is imperative. Here, we try to understand the underlying mechanism, risk factors, clinical characteristics, diagnosis and management options of the central fever. We also make an attempt to differentiate two noninfectious causes of fever in the NICU: paroxysmal sympathetic hyperactivity and central fever.
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Vanitha Rajagopalan,Deep Sengupta,Keshav Goyal,Surya Kumar Dube,Ashish Bindra,Shweta Kedia 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1
Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. The evidence to support or declare any intervention as harmful is scarce. In this review, we have presented the pathophysiology and workup, and a stepwise management protocol for intractable hiccups.
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