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Samenvatting Koorts op de IC
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Hoofdstuk koorts op de IC samenvatting van het boek: Marino's the ICU book
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Koorts op de ICNormale lichaamstemperatuur afhankelijk van leeftijd, plek van meten, tijdstip op de dag.
Meest accuraat meten kan met katheters ub art. pulmonalis, oesofagus of blaas( deze kunnen continu
meten).
Minder accuraat: rectaal, oraal of in oor.
Axillair niet aanbevolen.
Koorts:
lichaams temp> 38.3
immuungecomp. 38.0
Pyrogenen die reageren met de hypothalamus
koorts is een teken van inflammatie, niet meteen infectie
Hoogte van de koorts zegt niets over de ernst van de ziekte.
Oorzaken van koorts op de IC:
-sinusitis
-bloed transfusies en katheter sepsis / medicamenteus
- chirurgie
- pneumonie en LE
- myocardiale infarcering / endocarditis
- acalculeuze cholecystitis
-darm translocatie, darm infarcering, C. Difficile
- UWI
- diep veneuze tromboze
Niet infectieuze oorzaken:
SIRS
Vroege post-OK koorts
LE
plaatjes transfusie
mindervaak:
drug fever
biernierinsuf
acalculeuze cholecystitis
iatrogene koorts
SIRS kan komen door:
weefsel schade( ischemie of OK), translocatie van endotoxines uit GI.
Vroege post OK koorts
verdwijnen normaliter binnen 24-48 u
atelectase veroorzaakt geen koorts
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