Hyperthermia due to contents. Hyperthermia (high body temperature, fever). Medication-induced fever reduction

Psychological Dictionary. A.V. Petrovsky M.G. Yaroshevsky

Dictionary of psychiatric terms. V.M. Bleikher, I.V. Crook

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Neurology. Complete explanatory dictionary. Nikiforov A.S.

Hyperthermia- increased body temperature. One of the causes of hyperthermia, which can be accompanied by convulsions, psychomotor agitation, delirious syndrome, development of stupor or coma, is heat stroke that occurs when overheated. Its occurrence is facilitated by physical work, old age, and the use of anticholinergics, leading to impaired sweating, for example, in the treatment of parkinsonism. The skin of a patient with hyperthermia is usually dry, hot, with tachycardia, arterial pressure may be normal or reduced, a decrease in blood plasma pH is possible. The pupils are usually narrow with intact reactions to light, muscle tone is slightly increased.

An increase in temperature to 39–42 degrees can be a consequence of the use of inhalation anesthetics (ether for anesthesia, fluorotane, cyclopropane, etc.), as well as muscle relaxants, especially dithylin. When body temperature rises above 42 degrees, oxygen metabolism in the brain decreases, and the EEG shows a slowdown in biorhythms.

Hyperthermia malignant- a group of hereditary conditions characterized by a sharp increase in body temperature to 39–42 degrees in response to the introduction of inhaled anesthetics(ether for anesthesia, fluorotane, cyclopropane, etc.), as well as muscle relaxants, especially ditilin. In this case, insufficient muscle relaxation is noted at the beginning of anesthesia, and the occurrence of fasciculations in response to the administration of ditilin. The tone of the masticatory muscles often increases, creating difficulties for intubation, which leads to an increase in the dose of muscle relaxant and (or) anesthetic, which is accompanied by tachycardia, in 75% of cases, generalized muscle rigidity (rigid form of reaction). Soon after this, a rise in body temperature occurs, severe respiratory and metabolic acidosis and hyperkalemia develop. Muscle stiffness usually develops, arterial hypotension, marble cyanosis. Ventricular fibrillation and coma are possible.

Laboratory studies during Z.g. detect signs of respiratory and metabolic acidosis, high activity of creatine phosphokinase, myoglobinuria, hyperkalemia and hypermagnesemia, increased levels of lactate and pyruvate in the blood. Among late complications notice massive swelling of skeletal muscles, pulmonary edema, DIC syndrome, spicy renal failure. Tendency to Z.g. is inherited in most cases in an autosomal dominant manner with varying penetrance of the pathological gene. There is a risk of developing G.z. in patients suffering from Duchenne myopathy (see), central core myopathy (see), Thomsen's myotonia (see), chondrodystrophic myotonia (see Schwartz-Jampel syndrome), schizophrenia. Possible G. z. and in patients who have been taking antipsychotics and drugs containing levodopa for a long time. In the pathogenesis of G.z. The role of disinhibition of the dopamine system tubero-infundibular region of the hypothalamus is important. It is assumed that the development of G.z. associated with the accumulation of calcium in the sarcoplasm of muscle fibers. Autopsy sometimes reveals acute dystrophic changes in the brain and parenchymal organs.

Paroxysmal non-infectious hyperthermia - synonym: Temperature crises. Sudden increases in temperature up to 39–41 degrees, accompanied by a chill-like state, sensation internal tension, facial hyperemia, tachycardia. The elevated temperature persists for several hours, after which a lytic decrease usually occurs, accompanied by general weakness, weakness, noted within several hours. Crises can occur against the background normal temperature body or prolonged subfibrillation (permanent paroxysmal hyperthermia). They are not characterized by changes in the blood and, in particular, its leukocyte formula. One of possible manifestations vegetative dystonia (see).

Permanent non-infectious hyperthermia- syn.: Habitual hyperthermia. Permanent subfibrillation (37–38 degrees) for several weeks, less often – several months and even years. The increase in temperature is monotonous and does not have a circadian rhythm, is accompanied by a decrease or cessation of sweating, lack of response to antipyretic drugs (amidopyrine, etc.), and impaired adaptation to external cooling. Characterized by satisfactory tolerance of hyperthermia and preservation of ability to work.

G.p. more often manifests itself in children and young women during periods of emotional stress and is usually regarded as one of the signs of autonomic dystonia syndrome (see).

Hyperthermia habitual- see Permanent non-infectious hyperthermia.

Exogenous hyperthermia- most often the exogenous cause of hyperthermia is infectious agents (bacteria and their endotoxins, viruses, spirochetes, yeasts). It is believed that all exogenous pyrogens affect thermoregulatory structures through an intermediary substance - endogenous pyrogen (EP), identical to interleukin 1 (IL 1), which is produced by monocytes and macrophages. In the hypothalamus, EP stimulates the synthesis of prostaglandin E (PGE). PGE 1 activates the mechanisms of heat production and heat transfer by enhancing the synthesis of cyclic adenosine monophosphate (AMP). EP, contained in brain astrocytes, when released during a cerebral hemorrhage, can cause an increase in body temperature and also activate neurons responsible for slow-wave sleep. The latter circumstance explains lethargy and drowsiness during hyperthermia. Moderate hyperthermia (up to 38 degrees) during infectious diseases can have a positive effect on their course, as it promotes the development of immune responses.

One of the causes of exogenous hyperthermia may be heat stroke occurring during overheating (see). Exogenous hyperthermia can occur under the influence of drugs that reduce sweating (anticholinergics, MAO inhibitors, phenothiazines, phenamine, inhalational anesthetics, hormones, especially progesterone, synthetic nucleotides).

Endogenous central hyperthermia- occurs when organic lesions thermoregulatory center located in the preoptic area of the hypothalamus (vascular disorders, often petechial hemorrhages, chronic encephalitic process, tumors). Characterized by changes in daily fluctuations in body temperature, decreased sweating, and lack of response when taking antipyretic medications. Increased heat production is possible with thyrotoxicosis (may be 0.5–1.1 degrees higher than normal), with increased activity of the adrenal medulla, with menstruation, menopause and other conditions accompanied by endocrine imbalance.

Hyperthermia can also be caused by extreme physical exertion. For example, when running a marathon, body temperature sometimes rises to 39–40 degrees. The reason for the violation of thermoregulation may be a decrease in heat transfer. In this regard, hyperthermia is possible with the congenital absence of sweat glands, with ichthyosis, widespread burns and scarring of the integumentary tissue. Hyperthermia is possible with some hereditary diseases, including Thomsen's myotonia (see), Duchenne myopathy (see). It can be provoked by drugs that reduce sweating (anticholinergics, MAO inhibitors, phenothiazines, phenamine, inhalation anesthetics, progesterone, synthetic nucleotides).

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This term is often used to describe conditions in which the thermoregulatory system is either not functioning properly or is simply overloaded due to various internal or external factors. From this article you will learn what hyperthermia in children is, the main types and symptoms of hyperthermia in children, as well as how to help with hyperthermia in a child.

Why does fever occur in children?

Fever is a protective-adaptive reaction of the body that occurs in response to exposure to pathogenic stimuli and is characterized by a restructuring of thermoregulation processes, leading to an increase in body temperature, which stimulates the natural reactivity of the body.

Body temperature is measured in the armpit, oral cavity, rectum. In newborns, body temperature in the armpit is set within 37 °C, in infants - 36.7 °C, in the rectum - 37.8 °C. The same indicators are typical for older children.

Depending on the degree of increase in body temperature, there are:

subfebrile – 37.3 – 38.0°C;
febrile – 38.1 – 39.0 °C;
hyperthermic – 39.1°C and above.

The most common causes of fever:

spicy infectious diseases, infectious and inflammatory diseases;
severe metabolic disorders;
overheating;
allergic reactions;
endocrine disorders.

What is the difference between fever and hyperthermia? Fever occurs due to a shift in the set point in the hypothalamus, which is usually the end result of the triggering of several pyrogenic cytokines.

Causes of hyperthermia in children

Hyperthermia in a child can occur as a result of diseases accompanied by excessive heat production (exertional heat stroke, thyrotoxicosis), conditions associated with a decrease in heat loss (classical heat stroke, severe dehydration, autonomic dysfunction).

Hyperthermia syndrome should be considered a pathological variant of fever, in which there is a rapid and inadequate increase in body temperature, accompanied by impaired microcirculation, metabolic disorders and progressively increasing dysfunction of vital functions. important organs and systems.

Types of hyperthermia in children

It is very important to distinguish between red and white hyperthermia.

Red hyperthermia in children

More often we encounter “red” hyperthermia, which is more favorable prognostically (in this case, heat production corresponds to heat transfer). Main symptoms:

the skin is reddish, hot, moist to the touch, limbs are warm;
an increase in heart rate and respiration occurs, which corresponds to an increase in temperature (for every degree above 37°C, the respiratory rate becomes 4 more breaths per minute, and the heart rate increases by 20 beats per minute).
The baby's behavior is not disturbed, despite the increase in temperature to febrile levels.

White hyperthermia in children

She is the most dangerous. It is characterized by the following symptoms:

skin is pale, “marbled”, with bluish tint nail beds and lips;
the baby's limbs are cold to the touch;
positive symptom " white spot» when pressing on the skin;
behavior is disrupted - he becomes indifferent, lethargic, delirium and convulsions are possible.

The effect of antipyretic drugs on successful treatment hyperthermia is insufficient.

Emergency care for hyperthermia

If a child develops hyperthermia, should the temperature be lowered? Antipyretic therapy initially healthy children should be carried out at temperatures above 38.5 °C. However, if a boy or girl, against the background of fever, regardless of the severity of the condition, experiences a deterioration in his condition, symptoms such as chills, muscle pain, poor health, and pallor appear. skin, antipyretic therapy should be prescribed immediately.

Providing first aid for hyperthermia

Children at risk for developing complications due to fever require antipyretics for treatment medicines with red fever if the temperature is above 38.0 ° C, and with white fever - even with low-grade fever.

Children at risk for developing complications during febrile reactions include:

first months of life;
With febrile seizures in the anamnesis;
with pathology of the central nervous system;
with chronic heart and lung diseases;
with hereditary metabolic diseases.

Treatment of hyperthermia in children

Currently not used for the treatment of hyperthermia: acetylsalicylic acid (aspirin), analgin, Nise. The most acceptable for treatment are paracetamol and ibuprofen. For vomiting, use rectal antipyretic suppositories.

It has been established that if white hyperthermia is diagnosed in a baby, then the use of non-steroidal anti-inflammatory drugs in treatment is ineffective. Such children are prescribed intramuscular lytic mixtures, which include antipyretic drugs (analgin), vasodilators ("Papaverine", "No-shpa") and antihistamines(“Suprastin”, “Pipolfen”, “Diazolin”) – for children over 1 year old.

For the treatment of red hyperthermia:

the child must be revealed, exposed as much as possible, access must be provided fresh air avoiding drafts;
prescribe plenty of fluids (0.5 - 1 liter more age norm fluids per day);
use very carefully physical methods cooling.

Rubdowns in the treatment of hyperthermia in a child

The optimal water temperature for sponging with a damp sponge to treat fever varies from person to person. The very effectiveness of this method is controversial. This method allows for the use of evaporation, which would help cool the baby. Wiping is carried out only with a sponge (a square of thin foam rubber), it can be used in combination with antipyretics, and it takes up to 20 minutes before the effect appears. Use only cool or lukewarm water to keep your baby comfortable and not shivering! It is best if the water is 1 °C lower than the child’s body temperature, control this. If the temperature is 40 °C, then the water is 39 °C, if the baby’s body temperature is 39 °C, heat the water to 38 °C, etc.

Important! Never use cold water, alcohol, as it causes vasospasm and chills. Local application alcohol can cause severe poisoning due to absorption through the skin or inhalation of vapors. Moreover, as a result of the cooling effect of the skin, peripheral vasospasm occurs, which limits the child's ability to get rid of endogenous heat.

Medications for the treatment of hyperthermia

It is best to give antipyretics for treatment:

Paracetamol (“Acetaminophen”, “Panadol”, etc.) in a single dose of 10 – 15 mg/kg orally or rectally in suppositories 15 – 20 mg/kg (over 1 year);
Ibuprofen in a single dose of 5 – 10 mg/kg (over 1 year). You can alternate this combination of drugs, or you can give each drug separately. However, due to incorrect dosage of drugs, their toxic effect.
If within 30 - 45 min. the body temperature does not decrease, the child’s hyperthermia does not go away, it is necessary to administer an antipyretic mixture intramuscularly: 50% analgin solution for children under 1 year old - at a dose of 0.01 ml/kg, over 1 year old - 0.1 ml/year of life;
2.5% solution of "Pipolfen" ("Diprazine") for children under one year of age - at a dose of 0.01 ml/kg, over 1 year - 0.1 ml/year of life. A combination of drugs in one syringe is acceptable.
If there is no effect after 30 – 60 minutes. you can repeat the administration of the antipyretic mixture.

Emergency care for white hyperthermia

When its symptoms appear, vasodilators should be given orally or intramuscularly along with antipyretics:

“Papaverine” or “No-shpa” at a dose of 1 mg/kg orally and 2% papaverine solution for children under 1 year of age - 0.1 - 0.2 ml, over 1 year - 0.1 - 0.2 ml/year of life ,
or “No-shpa” solution at a dose of 0.1 ml/year of life,
or 1% solution of “Dibazol” at a dose of 0.1 ml/year of life.

If the baby continues to have hyperthermia, body temperature is monitored every 30 to 60 minutes.

Hospitalization for treatment of a child for hyperthermia

Children who are diagnosed with symptoms of the disease must be hospitalized. After decreasing to 37.5 °C, therapeutic hypothermic measures are stopped, since in the future it can decrease without additional interventions.

The desire to achieve a reduction in low-grade fever (less than 38 ° C) with the help of antipyretic drugs is unfounded. The body's defenses should not be suppressed! Remember that with most infections, the maximum temperature is set within 39 ° C, which does not threaten permanent health disorders. An increase in temperature is protective in nature, since many microorganisms reduce the rate of reproduction at elevated temperatures; it stimulates immune system, increases the detoxification function of the liver and the secretion of hormones.

The severity of a child’s condition with fever is indicated by:

weakened voice, whimpering, sobbing;
change in skin color, appearance of pallor and acrocyanosis;
dryness of the mucous membranes of the oral cavity;
weakening of attention, the appearance of lethargy.

The need for urgent hospitalization is indicated by:

appearance of a weak, moaning and hoarse voice;
constant crying;
if the child does not sleep at all or sleeps when waking up;
sharp pallor of the skin, cyanosis, marbling and especially an ash-gray tint of the skin;
complete indifference, lethargy, lack of reactions.

An increase in body temperature by 1 degree requires additional fluid administration in a volume of 10 ml per kg of body weight. First aid before the doctor arrives: try to give your son or daughter a decoction of raisins, dried apricots, and dried fruits.

You can administer Viburkol suppositories (prescribed in a single age-specific dosage), which have a detoxifying, analgesic, anticonvulsant, antipyretic, anti-inflammatory and sedative effect. When the symptoms of hyperthermia disappear, the treatment drug is discontinued.

Malignant hyperthermia in children

Is a state of acute skeletal muscle hypermetabolism that occurs during general anesthesia or immediately thereafter and is caused by volatile inhalational anesthetics, succinylcholine, and probably stress and exercise.

The syndrome is characterized by increased oxygen consumption, lactate accumulation, and the production of large amounts of carbon dioxide and heat.

The incidence of this syndrome is approximately 1 in 15,000 cases of general anesthesia. Abortive, moderate forms occur with a frequency of 1 in 4500 cases of anesthesia, and more often in children than in adults.

Mortality in the fulminant form of this syndrome without the use of dantrolene, which is a specific antidote, reaches 65 - 80%.

Causes of malignant hyperthermia

Malignant hyperthermia in a child is hereditary disease transmitted in an autosomal dominant manner. There are changes in the genetic region in the 19th pair of chromosomes, which is responsible for the structure and functions calcium channels sarcoplasmic reticulum of skeletal muscle myocytes. It has been established that malignant hyperthermia in boys and girls is quite often combined with two main syndromes: King-Denborough syndrome (short stature, musculoskeletal disorders, cryptorchidism) and central fiber disease (type I muscle fiber myopathy with central degeneration).

Medicines that cause malignant hyperthermia

Drugs that can provoke the development of the disease are called trigger agents. Traditionally, halogen-containing anesthetics, succinylcholine and some steroidal muscle relaxants are considered triggers.

As a result of direct or indirect exposure to trigger agents, the function of calcium channels of the sarcoplasmic reticulum is disrupted. Ionized calcium accumulates in the cytoplasm, binds to troponin and forms a stable actin-myosin complex, which causes pathological muscle contraction. Clinically, this is manifested by the appearance of muscle rigidity. Prolonged muscle contraction requires constant energy consumption. The result of increased metabolism is increased oxygen consumption, production of CO2 and heat. Damage to the myocyte membrane and rhabdomyolysis lead to hyperkalemia, hypercalcemia, myoglobinuria and increased levels of creatine phosphokinase in the blood. Metabolic and electrolyte disturbances cause depression of the cardiovascular system, cerebral edema and other severe disorders.

Symptoms of malignant hyperthermia

Classic signs and symptoms of hyperthermia in children include tachycardia, tachypnea, cyanosis, and generalized muscle rigidity. The earliest symptom is fast growth concentration of CO2 in exhaled gas. When studying CBS, a significant increase in PaCO2, a decrease in PaO2 and mixed acidosis are noted.

Already in the early phase of development of the condition, disturbances may be observed heart rate - ventricular tachycardia and extrasystole. As the pathological process progresses, bradycardia develops, followed by cardiac arrest. The cause of cardiac arrest is sudden hyperkalemia due to hypoxia and metabolic disorders.

The severity of muscle rigidity can vary, from moderate inflexibility to generalized muscle contracture. Curare-like muscle relaxants do not relieve muscle rigidity caused by malignant hyperthermia.

Death can occur as a result of cardiac arrest, brain damage, internal bleeding or damage to other body systems.

Treatment of malignant hyperthermia

A protocol for the management of patients with acute syndrome malignant hyperthermia:

Emergency management of hyperthermia: Stop all trigger medications immediately.
Begin hyperventilation with 100% oxygen.
For treatment, dantrolene should be administered intravenously at a dose of 2 - 3 mg/kg. The total dose of the drug, including repeated administrations, can be 10 mg/kg or more. (Dantrolene is a non-curare-like muscle relaxant that slows down the release of calcium ions from the sarcoplasmic reticulum. As a result, the contractility of muscle fibers is inhibited and hypermetabolism of the muscle cell is eliminated).
Catheterize the central vein.
Correct metabolic acidosis using intravenous administration sodium bicarbonate at a dose of 1 - 3 mEq/kg.
Actively cool the patient. Inject cooled saline solution 15 ml/kg intravenously every 10 minutes 3 times. Rinse the stomach with a cold solution, apply ice to the head, neck, and groin area.
Correction of hyperkalemia by intravenous administration of concentrated solutions of glucose with insulin (glucose 0.5 g/kg and insulin 0.15 U/kg), followed by the introduction of calcium chloride - 2 - 5 ml/kg.
To treat arrhythmia, novocainamide (1 ml/kg/hour up to 15 mg/kg) or lidocaine - 1 mg/kg is administered intravenously. Calcium channel blockers in combination with dantrolene are contraindicated.
Maintain diuresis (at least 1 ml/kg/hour) with intravenous mannitol (0.5 g/kg) or furosemide (1 mg/kg).
Monitor CBS, blood gases, and serum electrolyte concentrations every 10 minutes.
The use of dantrolene in combination with rational intensive care has made it possible in recent years to reduce mortality in fulminant forms of malignant hyperthermia in children to approximately 20%.

Now you know the main causes and symptoms of hyperthermia in children, as well as how hyperthermia in a child is treated. Health to your children!

Many parents have encountered a situation where a child suddenly develops a fever, turns pale and sometimes even loses consciousness. This condition also manifests itself in adults, accompanying injuries or infectious infections. Pathological changes caused by a strong increase in temperature are called hyperthermic syndrome. Without timely help, this condition is dangerous and can lead to serious consequences or death.

General description of the pathology

Hyperthermic syndrome is a pathological result of a strong increase in body temperature. It can reach 40 degrees or more, up to 42. Children often suffer from hyperthermia due to the fact that their body is not yet fully formed, and the regulation of all its functions is not yet perfect. This condition can also be caused by infections, such as flu or blood poisoning, allergic reactions, and excessive vitamin D intake. Overzealous treatment can also cause harm to the child.

Hyperthermic syndrome is a pathological result of a strong increase in body temperature

In adults, the thermoregulation system is already fully formed, so pathological conditions are always associated with the influence of internal or external influences.

Hyperthermic syndrome is included in the ICD-10 list and is designated by code R50, including fever of unknown origin, except those caused by childbirth or manifested in infants.

Etiology of the disease

In children, there are several main causes of hyperthermic syndrome: problems with the endocrine system, too much activity of the child, excessive wrapping or the influence of a nearby heater. In adults, the following circumstances can cause pathology:

high temperature and humidity of the environment in which a person is exposed to physical activity. It could also be too warm clothes or a long stay in the bathhouse;
reception medicines, for example, Ephedrine, Amitriptyline, Imizin and others. These pills disrupt the functioning of the hormonal system, causing the body’s heat transfer to decrease;
appears during fever during infections. The body reacts to the antigen and raises body temperature to fight viruses;
brain injuries, especially if the subcutaneous region is damaged. It also manifests itself in the post-resuscitation period in a state of severe weakening of body functions.

Ephedrine tablets can cause this disease

How does hyperthermic syndrome manifest?

Along with fever, other signs of the syndrome appear:

sluggish and inhibited reaction;
pale skin and feeling of cold;
breathing is weak and intermittent;
blood pressure drops, and the pulse, on the contrary, increases;
the body loses moisture, symptoms of dehydration appear;
convulsions begin;
a person may lose consciousness or suffer from hallucinations.

Treatment of hyperthermic syndrome

Therapy should be started as early as possible, before the situation becomes too dangerous. The temperature is measured at least once every half hour. For hyperthermic syndrome in children, they begin by removing excess clothing from the child, removing blankets, and wrapping him in a damp sheet. Be sure to call ambulance, and before she arrives, provide the victim with the necessary support, combining medications and physical cooling methods.

Be sure to drink plenty of fluids

Give medicines to children by injection or drink; adults can also be given tablets.

The following methods are used to combat the syndrome:

Give the patient an antipyretic dosage based on weight. This may be Paracetamol or its substitutes, but they can be used no more than once every 4 hours;
cool the human body - apply compresses to the places of the main vessels - armpits, groin area, abdomen. Also cover the forehead with a damp cloth, but do not expose the victim to a draft;
Rub the person's skin with a weak vinegar or alcohol solution, or with a simple wet cloth. Please note that alcohol penetrates the skin, so this does not apply to children;
Give the person plenty of drink at a moderate temperature - it should not be too hot or cold;
The patient can be given an enema with lukewarm water. This method is suitable for small children. Antipyretic suppositories are also acceptable;
if accompanying symptoms appear, then apply symptomatic treatment to eliminate them;
if you have undergone special training and know how to give injections, give the patient lytic mixture from antipyretics.

To ensure successful treatment, do not under any circumstances use drugs and methods that directly or indirectly increase the temperature - no hot drinks, compresses, mustard plasters. It is not necessary to reduce it to full norm, especially in children. It is enough to remove just one to one and a half degrees. Reducing the temperature too quickly is just as bad as not doing it at all. It is better to hospitalize the patient as quickly as possible.

In adults, hyperthermic syndrome, unlike in children, practically does not occur due to simple overheating. It can be a symptom of many dangerous abnormalities listed among the causes of symptoms. Be careful with blood pressure medications, vascular spasm medications, or heart pills so you don't do more harm than good. They should not be given to children without the direct instructions of a doctor.

Hyperthermia syndrome has a real danger to human life. This pathological condition is especially harmful for people with cardiovascular diseases, as it puts a huge burden on this body system.

In severe form, hyperthermia leads to serious consequences, including death. It is better to avoid overheating by following simple rules:

Dress according to the weather, do not overload your body in the heat.
Drink in any weather more water or other liquid.
Do not over-wrap your child, especially if he is already sick and the temperature has already risen.
Do not hesitate to see a doctor if you have a head injury, infection or hormonal diseases. In such a situation, hyperthermia can occur at any time.
If the temperature rises quickly or reaches dangerous indicators, urgently call an ambulance.

In children and older people, the body has less strength to fight the syndrome, so it is better to consult a doctor on a regular basis.

If you have a high temperature, you must call an ambulance

Conclusion

Many people ask the question: “Hyperthermic syndrome - what is it?” But few people know how dangerous this condition is. Parents wrapping up their children and not understanding why the child looks unwell during a walk. Adults who prefer to endure the disease on their feet and then simply collapse from increased symptoms. Do not harm your body, and it will thank you with good health, mood and performance.

What is hyperthermia? This is the accumulation of excess heat in the body. In simple terms, this is overheating. Body temperature rises, its release into the external environment is disrupted. There is also another situation - excess heat coming from outside. Similar condition appears when heat production prevails over its consumption. The appearance of this problem negatively affects the functioning of the entire body. The circulatory and cardiovascular systems are under great strain. Hyperthermia according to ICD-10 is a fever of unknown origin, which can also occur after childbirth. Unfortunately, this also happens. ">

Types of hyperthermia

They are as follows:

Red. Considered the safest. There is no circulatory disturbance. Peculiar physiological process cooling the body, which prevents overheating of internal organs. Signs - skin color changes to pink or red, the skin is hot when touched. The man himself is hot, he has heavy sweating.

White. When talking about what hyperthermia is, we cannot ignore this type. It poses a danger to human life. Peripheral vasospasm occurs circulatory system, which leads to disruption of the heat transfer process. If this condition lasts for a long time, it will inevitably lead to swelling of the brain, impaired consciousness and the appearance of seizures. The person is cold, his skin becomes pale with a bluish tint.
Neurogenic. The cause of its appearance is a brain injury, benign or malignant tumor, local hemorrhage, aneurysm. This species is the most dangerous.
Exogenous. Occurs when the ambient temperature rises, which contributes to the entry of a large amount of heat into the body.
Endogenous. A common cause of appearance is toxicosis.

Why is there a problem?

The human body can regulate the temperature of not only the entire body, but also the internal organs. This event involves two processes - heat production and heat transfer.
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Heat is produced by all tissues, but the liver and skeletal muscles are most involved in this work.

Heat transfer occurs thanks to:

Small blood vessels, which are located near the surface of the skin and mucous membranes. When expanding, they increase heat transfer, and when narrowing, they reduce it. The hands play a special role. Through small vessels located on them, up to sixty percent of the heat is removed.
Skin. It contains sweat glands. As the temperature rises, sweating increases. This leads to cooling. The muscles begin to contract. The hairs growing on the skin rise. This way the heat is retained.
Breathing. When you inhale and exhale, liquid evaporates. This process increases heat transfer.

There are two types of hyperthermia: endogenous (impaired heat transfer occurs under the influence of substances produced by the body itself) and exogenous (arising under the influence of factors external environment).

Causes of endogenous and esogenous hyperthermia

The following reasons are identified:

Excess hormones from the adrenal glands, ovaries, thyroid gland. Endocrine pathologies of these organs provoke increased heat production.
Reduced heat transfer. Increased tone nervous system causes a narrowing of blood vessels, which leads to their sharp spasm. For this reason, the temperature jumps up within a few minutes. On the thermometer scale you can see 41 degrees. The skin becomes pale. That is why experts call this condition pale hyperthermia. The reason that most often provokes this problem is obesity (third or fourth degree). Subcutaneous tissue overweight people are highly developed. Excess heat cannot “break through” through it. It stays inside. An imbalance of thermoregulation occurs.

Exogenous heat accumulation. Factors that provoke it:

Finding a person in a room with high temperature. This could be a bathhouse, a hot shop. Long stays under the hot sun are no exception. The body is unable to cope with excess heat, and a failure occurs in the process of heat transfer.
High humidity. The pores of the skin begin to become clogged, and sweating does not occur in full. One component of thermoregulation does not function.
Clothing that does not allow air and moisture to pass through.

Main factors causing the problem

The main causes of hyperthermia syndrome include the following:

Brain damage.
Ischemic or hemorrhagic stroke.
Respiratory tract disease.
Food intoxication and pathological processes occurring in the urinary system.
Viral infection and skin diseases with suppuration.
Lesions of abdominal and retroperitoneal organs.

Let's move on to a more detailed study of the causes of hyperthermia:

Stages of hyperthermia

Before determining what kind of help to provide for hyperthermia, let's talk about its stages. This is what determines which treatment methods to use.

Adaptive. Tachycardia, rapid breathing, vasodilation and severe sweating appear. These changes themselves try to normalize heat transfer. Symptoms: headache, muscle pain, weakness. If help is not provided in time, the disease enters the second stage.
Excitement stage. A high temperature appears (up to thirty-nine degrees or more). There is confusion, increased heart rate and breathing, increased headache, weakness and nausea. The skin is pale and damp.
The third stage is characterized by respiratory and vascular paralysis. This condition is very dangerous for human life. It is at this moment that it is necessary urgent Care with hyperthermia. Delay may result in death.

Pediatric hyperthermia

An elevated temperature in a child indicates some kind of illness or inflammatory process, occurring in the baby’s body. In order to help him, it is necessary to establish a diagnosis and determine what ailment the existing symptoms relate to.

Hyperthermia in children is very dangerous. It can lead to complications. So it requires emergency treatment. Symptoms of hyperthermia in a child are as follows:

Temperature above thirty-seven degrees. This indicator can be measured in a child: in the groin, in the mouth, in the rectum.
Weakness and drowsiness.
Breathing is rapid, as is heartbeat.
Sometimes convulsions and delirium appear.

If your body temperature is not higher than thirty-eight degrees, experts recommend not lowering it. The baby's body must fight on its own. Interferon is produced, which strengthens the child’s defenses

But every rule has an exception. If a child suffers from disorders of the central nervous system, then already at thirty-eight degrees the temperature should be reduced.

How to help your baby

For hyperthermia in children, emergency care is as follows.

1. Red type of disease:

The child is given a cool drink.
Under no circumstances should you wrap your baby up; on the contrary, remove excess clothing. Excess heat will escape through the skin.
Cool lotions are placed on the child's forehead.
Cool bandages on your wrist will help reduce your temperature.
If the temperature rises to thirty-nine degrees, give your child antipyretic medications.

2. White hyperthermia. In this case, you should act a little differently:

The baby is given a warm drink.
It is advisable to rub the limbs to help the child warm up.
You should wear warm socks on your feet.
It wouldn't hurt to wrap your child up or dress him warmer.
Raspberry tea is suitable to reduce the temperature. This is a product that has been proven over the years.

If all these actions do not help bring down the temperature, then the next step is medical help.

A little more about children

Now we will talk about hyperthermia in newborns. Sometimes parents of babies start to panic for no reason. To prevent this from happening, you should familiarize yourself with this information.

The baby has a temperature of thirty-seven degrees. First, pay attention to your baby's behavior. If he is calm, eats and sleeps well, smiles and is not capricious, then there is no need to worry in advance. Remember that a temperature of thirty-seven degrees in a child up to a month is normal.

Is a temperature of thirty-seven degrees dangerous for a newborn? As stated above, no. The baby's body adapts to the environment. That's why the temperature periodically jumps.

It doesn’t hurt to know that a baby with a body temperature of thirty-seven degrees can be bathed. Don't worry about what happens after water procedures she stood up a little. Physical exercise and warm water lead to temporary hyperthermia.

Temperature fluctuations in children under one year of age are normal. During this period, thermoregulation is just beginning to form. But if the temperature exceeds thirty-seven, then without medical care no longer possible. Especially if other symptoms begin to appear: pallor or redness of the skin, moodiness, lethargy, refusal to eat.

Genetic disease

Malignant hyperthermia is hereditary. Most often found in anesthesiology. Metabolic processes are disrupted in muscle tissue. The danger of this condition is that during the use of anesthesia or anesthesia, the heart rate increases, the temperature rises greatly, and shortness of breath appears. If timely assistance is not provided, the person may die.

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The disease is inherited through generations. If one of the relatives has been diagnosed with it, then the person automatically falls into the risk zone. During anesthesia, medications are used that will not provoke an attack.

Now about the symptoms of the disease:

In the exhaled air a large number of carbon dioxide.
Breathing is rapid and shallow.
Heart rate is more than ninety beats per minute.
The temperature rises sharply to forty-two degrees.
The skin turns blue.
A spasm of the chewing muscles appears and the tone increases.
There are surges in blood pressure.

Malignant hyperthermia: treatment and complications

For malignant hyperthermia, emergency care should be provided immediately. Treatment of this disease consists of two stages.

Rapid cooling, maintaining this state.
Introduction of the drug "Dantrolene".

The first stage is necessary to prevent damage to the central nervous system and metabolic disorders.

The second stage is an addition to the first.

The best results can be obtained if muscle tone has not reached the generalized stage.

This type of hyperthermia has a high mortality rate. That is why it is necessary to immediately take all measures to prevent an attack.

During the operation, the anesthesiologist has at hand all the necessary drugs to relieve the attack. Instructions are also included with them.

The same manipulations are carried out if malignant hyperthermia occurs in children.

To complications of this disease can be attributed:

Kidney failure.
Destruction of muscle cells.
Blood clotting disorder.
Arrhythmia.

First aid for hyperthermia

Before it is rendered medication assistance with a sharp increase in temperature, a person should be helped where his illness overtook him.

Take off excess clothes. If a person is under the hot sun, he should be moved to the shade. In the room, open a window or point a fan at the patient. Give the person plenty of fluids. If the skin is pink, the drink should be cool. If pale, the liquid should be warm.

Place a heating pad with ice or frozen foods in the groin area, under the armpit, or on the neck. The body can be wiped with a solution of table vinegar or vodka.

For pallid hyperthermia, treatment involves warming the extremities. Vascular spasm is eliminated, the process of thermoregulation is normalized.

Drug treatment is provided in a hospital or by an ambulance:

For pale hyperthermia, antispasmodics are administered. When red - cool solutions.
If the attack began during surgery, the person is assisted by the resuscitation team. The patient is given infusion solutions and anti-seizure medications.

Diagnostics

Fever is a symptom of many diseases. To identify the cause, a comprehensive examination should be carried out.

An anamnesis is being collected.
The patient is examined.
Tests are prescribed: blood, urine.
A chest x-ray is required.

To determine pathological changes, a bacteriological or serological study is prescribed.

You already know what hyperthermia is. As you can see, this disease is not to be joked about. If the temperature cannot be brought down, seek medical help immediately.

Types of hyperthermia

Exogenous or physical hyperthermia. The exogenous type of hyperthermia occurs when a person spends a long time in conditions of high humidity and elevated temperature. This leads to overheating of the body and the development of heat stroke. The main link in the pathogenesis of hyperthermia in this case is a disorder of normal water and electrolyte balance.

Endogenous or toxic hyperthermia. With the toxic type of hyperthermia, excess heat is produced by the body itself, and it does not have time to remove it outside. Most often, this pathological condition develops against the background of certain infectious diseases. The pathogenesis of endogenous hyperthermia is that microbial toxins can increase ATP synthesis and ADP by cells. The breakdown of these high-energy substances releases a significant amount of heat.

Pale hyperthermia

This type of hyperthermia occurs as a result of significant irritation of the sympathoadrenal structures, which causes a sharp spasm of the blood vessels.

Pale hyperthermia or hyperthermic syndrome occurs as a result of pathological activity of the thermoregulation center. The development may be caused by some infectious diseases, as well as by the administration of drugs that have a stimulating effect on the sympathetic part of the nervous system or have an adrenergic effect. In addition, the causes of pale hyperthermia are general anesthesia with the use of muscle relaxants, traumatic brain injury, stroke, brain tumors, that is, all those conditions in which the functions of the hypothalamic temperature regulation center may be impaired.

The pathogenesis of pale hyperthermia consists of a sharp spasm of skin capillaries, which leads to a significant decrease in heat transfer and, as a result, increases body temperature.

With pale hyperthermia, the body temperature quickly reaches life-threatening values - 42 - 43 degrees C. In 70% of cases, the disease ends in death.

Symptoms of physical and toxic hyperthermia

Symptoms and stages of endogenous and exogenous hyperthermia, as well as their clinical picture similar. The first stage is called adaptive. It is characterized by the fact that at this moment the body is still trying to regulate temperature due to:

Tachycardia;
Increased sweating;
Tachypnea;
Dilation of skin capillaries.

Patients complain of headache and muscle pain, weakness, and nausea. If he is not provided with emergency assistance, the disease enters the second stage.

This is called the arousal stage. Body temperature rises to high values (39 - 40 degrees C). The patient is adynamic, stunned. Complains of nausea and severe headache. Sometimes there may be short-term episodes of loss of consciousness. Breathing and pulse are increased. The skin is moist and hyperemic.

During the third stage of hyperthermia, paralysis of the vasomotor and respiratory centers develops, which can lead to the death of the patient.

Hypothermia of the physical and toxic type is accompanied, as we have already said, by redness of the skin and therefore it is called “pink”.

Causes of hyperthermia

Hyperthermia occurs at maximum exertion physiological mechanisms thermoregulation (sweating, dilation of skin vessels, etc.) and, if the causes that cause it are not eliminated in time, it steadily progresses, ending at a body temperature of about 41-42°C with heat stroke.

The development of hyperthermia is facilitated by increased heat production (for example, during muscle work), disruption of thermoregulation mechanisms (anesthesia, intoxication, some diseases), and age-related weakness (in children of the first years of life). Artificial hyperthermia is used in the treatment of certain nervous and sluggish chronic diseases.

First emergency aid for hyperthermia

When the body is elevated, the first thing to do is to find out whether it is caused by fever or hyperthermia. This is due to the fact that in case of hyperthermia, measures to reduce the elevated temperature should be immediately started. In case of moderate fever, on the contrary, it is not necessary to urgently lower the temperature, since its increase has a protective effect on the body.

Methods used to reduce temperature are divided into internal and external. The first include, for example, lavage with ice water and extracorporeal blood cooling, but it is impossible to do them yourself, and they can cause complications.

External cooling methods are easier to use, well tolerated and very effective.

Conductive cooling techniques include applying hypothermic packs directly to the skin and ice water baths. Alternatively, you can apply ice to your neck, armpits and groin area.
Convective cooling techniques include using fans and air conditioners, and removing excess clothing.
A cooling technique is also often used, which works by evaporating moisture from the surface of the skin. The person's clothes are removed, the skin is sprayed with cool water, and a fan is used for additional cooling or a window is simply opened.

Medication-induced fever reduction

For severe hyperthermia, provide supplemental oxygen and install a continuous 12-line ECG to monitor cardiac activity and signs of arrhythmia.
Use diazepam to relieve chills.
For “red” hyperthermia: it is necessary to expose the patient as much as possible, to ensure access to fresh air (avoiding drafts). Prescribe plenty of fluids (0.5-1 liters more than the age norm of fluid per day). Use physical cooling methods (blowing with a fan, a cool wet bandage on the forehead, vodka-vinegar (9% table vinegar) rubbing - wipe with a damp swab). Prescribe paracetamol orally or rectally (Panadol, Calpol, Tylinol, Efferalgan, etc.) in a single dose of 10-15 mg/kg orally or in suppositories 15-20 mg/kg or ibuprofen in a single dose of 5-10 mg/kg (for children older than 1 year). If the body temperature does not decrease within 30-45 minutes, an antipyretic mixture is administered intramuscularly: 50% analgin solution (for children under 1 year of age, dose 0.01 ml/kg, over 1 year of age, dose 0.1 ml/year life), 2.5% solution of pi-polfen (diprazine) for children under one year of age at a dose of 0.01 ml/kg, over 1 year - 0.1-0.15 ml/year of life. A combination of drugs in one syringe is acceptable.
For “white” hyperthermia: simultaneously with antipyretics (see above), vasodilators are given orally and intramuscularly: papaverine or noshpa at a dose of 1 mg/kg orally; 2% papaverine solution for children under 1 year of age - 0.1-0.2 ml, over 1 year of age - 0.1-0.2 ml/year of life or noshpa solution at a dose of 0.1 ml/year of life or 1% dibazole solution at a dose of 0.1 ml/year of life; you can also use a 0.25% solution of droperidol at a dose of 0.1-0.2 ml/kg intramuscularly.

Treatment of hyperthermia

Treatment of hyperthermia consists of eliminating the causes that caused hyperthermia in the body; cooling; if necessary, use dantrolene (2.5 mg/kg orally or intravenously every 6 hours).

What not to do with hyperthermia

Wrap the patient in plenty of warm things (blankets, clothes).

Use warming compresses for hyperthermia - they contribute to overheating.

Give very hot drinks.

Treatment of malignant hyperthermia

If the fact of rapidly progressing hyperthermia is established, the drugs listed above must be discontinued. Anesthetic agents that do not lead to hyperthermia include tubocurarine, pancuronium, nitrous oxide and barbiturates. They can be used if it is necessary to continue anesthesia. Due to the possibility of developing ventricular arrhythmia, prophylactic use of procainamide and phenobarbital in therapeutic doses is indicated. It is necessary to provide cooling procedures: placing containers with ice or cold water. Oxygen inhalation should be immediately established and sodium bicarbonate (3% solution 400 ml) should be administered intravenously. In severe cases, resuscitation measures are indicated. Hospitalization is required in the intensive care unit.

Causes

Normally, when the external temperature decreases, the superficial vessels of the skin narrow and (in severe cases) arteriovenous anastomoses open. These adaptive mechanisms contribute to the concentration of blood circulation in more deep layers body and maintaining the temperature of internal organs at the proper level in conditions of hypothermia.

At high ambient temperature a reverse reaction takes place: superficial vessels dilate, blood flow in the shallow layers of the skin is activated, which promotes heat transfer through convection, sweat evaporation also increases and breathing quickens.

In various pathological conditions, a breakdown of the thermoregulation mechanisms occurs, which leads to an increase in body temperature - hyperthermia, its overheating.

At extreme external conditions or disruption of the mechanisms of heat production and (or) heat transfer, an increase in body temperature and overheating of its structures occur.

Internal (endogenous) causes of thermoregulation disorders:

damage to the thermoregulation center located in the brain as a result of hemorrhage in the tissue or thromboembolism of the supply vessels (stroke), traumatic brain injury, organic lesions of the central nervous system;
overdose of stimulants that activate metabolism;
excessive stimulating effect of cortical centers on the thermoregulation center located in the hypothalamus (intense psychotraumatic effects, hysterical reactions, mental illness and so on.);
extreme muscle work in conditions of difficult heat transfer (for example, the so-called “drying” in professional sports, when intense training is carried out in thermal clothing);
activation of metabolism somatic pathologies(for diseases of the thyroid gland, adrenal glands, pituitary gland, etc.);
pathological contractile thermogenesis (tonic tension skeletal muscles which is accompanied by an increase in heat production in the muscles, with tetanus, poisoning with certain substances);
separation of oxidation and phosphorylation processes in mitochondria with the release of free heat under the influence of pyrogen substances;
spasm of skin vessels or decreased sweating as a result of intoxication with anticholinergics, adrenergic agonists.

External causes of hyperthermia:

high ambient temperature combined with high air humidity;
work in hot production shops;
long stay in a sauna, bath;
clothing made from fabrics that impede heat transfer (the air layer between clothing and the body is saturated with vapor, which makes sweating difficult);
lack of adequate ventilation of premises (especially in large crowds of people, in hot weather).

Kinds

According to the provoking factor, they are distinguished:

endogenous (internal) hyperthermia;
exogenous (external) hyperthermia.

According to the degree of temperature increase:

subfebrile – from 37 to 38 ºС;
febrile – from 38 to 39 ºС;
pyretic – from 39 to 40 ºС;
hyperpyretic or excessive – over 40 ºС.

By severity:

compensated;
decompensated.

By external manifestations:

pale (white) hyperthermia;
red (pink) hyperthermia.

Separately, rapidly developing hyperthermia is distinguished, with rapid decompensation and an increase in body temperature to life-threatening (42-43 ºС) - heat stroke.

Forms of heat stroke (by dominant manifestations):

asphyxial (respiratory disorders predominate);
hyperthermic (the main symptom is high body temperature);
cerebral (brain) (accompanied by neurological symptoms);
gastroenterological (dyspeptic manifestations come to the fore).

Main distinctive features heat stroke – rapidly increasing symptoms, severity general condition, previous exposure to external provoking factors.

Signs

Hyperthermia has the following manifestations:

increased sweating;
tachycardia;
hyperemia of the skin, skin that is hot to the touch;
significant increase in breathing;
headache, possible dizziness, flashing spots or darkening of the eyes;
nausea;
feeling of heat, sometimes hot flashes;
unsteadiness of gait;
short-term episodes of loss of consciousness;
neurological symptoms in severe cases (hallucinations, convulsions, confusion, stunning).

A characteristic feature of pale hyperthermia is the absence of hyperemia of the skin. The skin and visible mucous membranes are cold, pale, sometimes cyanotic, covered with a marbled pattern. Prognostically this type hyperthermia is the most unfavorable, since in conditions of spasm of superficial vessels, rapid overheating of internal vital organs occurs.

There are no signs of heat stroke characteristic features, the main distinguishing features are rapidly increasing symptoms, the severity of the general condition, and previous exposure to external provoking factors.

Metabolic changes

Hyperthermia is accompanied by an increase and qualitative violations metabolism, loss of water and salts, impaired blood circulation and oxygen delivery to the brain, causing agitation, sometimes convulsions and fainting.

Development of hyperthermia

High temperature with hyperthermia is more difficult to tolerate than with many febrile diseases. The development of hyperthermia is facilitated by increased heat production (for example, during muscle work), disruption of thermoregulation mechanisms (anesthesia, intoxication, some diseases), and age-related weakness (in children of the first years of life).

Artificial hyperthermia

Artificial hyperthermia is used in the treatment of certain nervous and sluggish chronic diseases, as well as in complex radiotherapy of tumors.

There are:

Local Artificial Hyperthermia (LG)
General Controlled Hyperthermia (WBGT).

This treatment technology is used mainly as a sensitizer for radiation and chemotherapy effects on tumors or tumor metastases. The technology has limited distribution due to high technical complexity and unclear mechanisms of action on the disease. In the USSR, the pioneer of the use of hyperthermia in medicine was Professor Beluzek (Leningrad). A whole school of hyperthermia was created at the Belarusian Republican Oncology Center. In Russia, the main centers of therapeutic hyperthermia are N. Novgorod and Novosibirsk.

Criticism

According to media reports, the procedure of artificial hyperthermia is prohibited by the Ministry of Health of the Russian Federation.

Danger to the body

Hyperthermia poses the greatest danger to people with cardiovascular diseases; in these cases, even death is possible.

Notes

Links

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Synonyms:

See what “Hyperthermia” is in other dictionaries:

Hyperthermia… Spelling dictionary-reference book

Overheating, hyperpyrexia Dictionary of Russian synonyms. hyperthermia noun, number of synonyms: 3 hyperpyrexia (2) ... Synonym dictionary

- (from hyper... and Greek therme heat) overheating of the body of warm-blooded animals and humans due to a violation of the relationship between heat production and heat transfer. A person with a body temperature of 41-42.C may experience heatstroke.… … Big Encyclopedic Dictionary

HYPERTHERMIA, abnormally high body temperature, close to 41 ° C or higher. Occurs due to overheating (as with HEAT STROKE) or FEVER... Scientific and technical encyclopedic dictionary

hyperthermia- and, f. hyperthermie, German Hyperthermie gr. hyper over + thermoe heat. honey. Overheating of the body. Hyperthermic oh, oh. Krysin 1998. Lex. SIS 1964: hyperthermia/i... Historical Dictionary Gallicisms of the Russian language

HYPERTHERMIA- HYPERTHERMIA, HYPOTHERMIA, see Thermoregulation. HYPERTHYROID03, HYPOTHYROIDOSIS, conditions of the body that are the result of increased (hyper) or, conversely, weakened (hypo) intrasecretory activity of the thyroid gland (see also Athyroidism, Bazedova ... Great Medical Encyclopedia

hyperthermia- Abnormally high body temperature caused by high ambient temperature or thermal radiation, or their combined effect. [GOST R 53389 2009] Topics protection of the marine environment General terms safety EN hyperthermia ... Technical Translator's Guide

The term hyperthermia The term in English hyperthermia Synonyms increased body temperature Abbreviations Related terms ablation, coagulation, multifunctional nanoparticles in medicine, nanopharmacology, magnetic therapeutic nanoparticles, ... ... Encyclopedic Dictionary of Nanotechnology

- [te], and; and. [from Greek hyper over and thermoē warmth, heat]. Honey. Overheating of the body of warm-blooded animals and humans due to a violation of the relationship between the formation of heat in the body and heat transfer. * * * hyperthermia (from hyper... and Greek... ... encyclopedic Dictionary

- (hyper... + thermoe warmth, heat) honey. overheating of the body cf. hypothermia). New dictionary foreign words. by EdwART, 2009. hyperthermia (te), and, pl. no, w. (German: Hyperthermie, French: hyperthermie... Dictionary of foreign words of the Russian language

Books

Phylogenetic theory of general pathology. Pathogenesis of metabolic pandemics. Arterial hypertension: Monograph, Titov V.N. , A new biologically based phylogenetic approach to the formation of a unified algorithm for the pathogenesis of diseases clarifies the diagnostic value of such nonspecific pathological tests... Category: Popular and alternative medicine Series: Scientific Thought Publisher: