BACKGROUND Some patients present to the intensive care unit due to noninfectious pathologies resulting in fever,especially acute neurological injuries,including brain trauma and intracranial haemorrhage.The cause has ...BACKGROUND Some patients present to the intensive care unit due to noninfectious pathologies resulting in fever,especially acute neurological injuries,including brain trauma and intracranial haemorrhage.The cause has been identified to be central hyperthermia characterized by a high core temperature and a poor response to antipyretics and antibiotics.However,no proper guidelines on how to treat central hyperthermia have been developed for clinical practice.CASE SUMMARY A 63-year-old woman was transferred to our hospital due to injury after a traffic accident.Eight hours after admission,her pupils enlarged bilaterally from 2.5 mm to 4.0 mm.She developed severe coma and underwent decompressive craniectomy.She was diagnosed with central hyperthermia after surgery and was prescribed bromocriptine.The standard dose of bromocriptine could not control her hyperpyrexia,and we prescribed 30 mg a day to control her temperature.CONCLUSION Bromocriptine may be effective in controlling central hyperthermia and have a dosage effect.展开更多
Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe ...Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe TBI. This prospective controlled study was conducted on 50 severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission. Then, they were randomly assigned into 2 groups. Bromocriptine group (25) received bromocriptine 7.5 mg/day during 24 hours from admission through a naso-gastric (NG) feeding tube. Control group (25) received conventional treatment only. Temperature was measured every 2 hours. The antipyretic measures used were the same across all patients enrolled. The primary outcome was number of patients diagnosed with central hyperthermia. After the discharge of all patients, there was a statistically significant difference between the 2 groups in number of patients diagnosed with central hyperthermia (6 (24%) in bromocriptine group Vs 18 (72%) in control, p = 0.002). There were no differences in hospital length of stay (p = 0.904) or mortality (p = 0.393). Early administration of bromocriptine in severe TBI may be associated with lower incidence of central hyperthermia with no effect on length of stay or mortality.展开更多
Congenital myopathies are a group of minimally progressive or non-progressive neuromuscular conditions which is present from birth. A classical type of congenital myopathy is called central core disease. This conditio...Congenital myopathies are a group of minimally progressive or non-progressive neuromuscular conditions which is present from birth. A classical type of congenital myopathy is called central core disease. This condition is often confused with muscular dystrophy. Central core disease can be associated with comorbidities which affect pregnancy and its management. In this case series, we describe two cases, who are siblings affected by the same condition but at varied levels and their management during pregnancy. We also would like to illustrate a management plan for congenital myopathy during pregnancy, for a good maternal and fetal outcome.展开更多
文摘BACKGROUND Some patients present to the intensive care unit due to noninfectious pathologies resulting in fever,especially acute neurological injuries,including brain trauma and intracranial haemorrhage.The cause has been identified to be central hyperthermia characterized by a high core temperature and a poor response to antipyretics and antibiotics.However,no proper guidelines on how to treat central hyperthermia have been developed for clinical practice.CASE SUMMARY A 63-year-old woman was transferred to our hospital due to injury after a traffic accident.Eight hours after admission,her pupils enlarged bilaterally from 2.5 mm to 4.0 mm.She developed severe coma and underwent decompressive craniectomy.She was diagnosed with central hyperthermia after surgery and was prescribed bromocriptine.The standard dose of bromocriptine could not control her hyperpyrexia,and we prescribed 30 mg a day to control her temperature.CONCLUSION Bromocriptine may be effective in controlling central hyperthermia and have a dosage effect.
文摘Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe TBI. This prospective controlled study was conducted on 50 severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission. Then, they were randomly assigned into 2 groups. Bromocriptine group (25) received bromocriptine 7.5 mg/day during 24 hours from admission through a naso-gastric (NG) feeding tube. Control group (25) received conventional treatment only. Temperature was measured every 2 hours. The antipyretic measures used were the same across all patients enrolled. The primary outcome was number of patients diagnosed with central hyperthermia. After the discharge of all patients, there was a statistically significant difference between the 2 groups in number of patients diagnosed with central hyperthermia (6 (24%) in bromocriptine group Vs 18 (72%) in control, p = 0.002). There were no differences in hospital length of stay (p = 0.904) or mortality (p = 0.393). Early administration of bromocriptine in severe TBI may be associated with lower incidence of central hyperthermia with no effect on length of stay or mortality.
文摘Congenital myopathies are a group of minimally progressive or non-progressive neuromuscular conditions which is present from birth. A classical type of congenital myopathy is called central core disease. This condition is often confused with muscular dystrophy. Central core disease can be associated with comorbidities which affect pregnancy and its management. In this case series, we describe two cases, who are siblings affected by the same condition but at varied levels and their management during pregnancy. We also would like to illustrate a management plan for congenital myopathy during pregnancy, for a good maternal and fetal outcome.
