Fever vs Hyperthermia Fever: • Regulated in the hypothalamic thermoregulatory center • "Set point" raised by prostaglandin E2 • Triggered by pyrogens: Endotoxins, Toxins, Cytokines (IL-1, TNF-a1pha, IL-6, etc.) • Antipyretics block prostaglandin E2 production • Treatment: Use antipyretics to block prostaglandin E2 production and decrease the elevated hypothalamic set-point Hyperthermia: • Not regulated by hypothalamic set point • Body temperature rises uncontrollably • Can be rapidly fatal • Causes: Drugs: Ecstasy, atropine; Heat stroke; Malignant hyperthermia; Neuroleptic malignant syndrome; Serotonin syndrome • Treatment: - Identify underlying cause - Antipyretics are of no use - Cool damp sponge bath (no submersion) to allow for evaporative heat loss - Cool fluids peripherally - Cooling blankets can cause harm as they lead to peripheral vasoconstriction, preventing heat loss from the skin BWH Medicine Chiefs @BrighamChiefs #Fever #Hyperthermia #comparison #diagnosis #management #treatment
