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  Új Válasz 2021-04-05 22:00:48 #6708

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  Lázcsillapításról ezt mondja az Uptodate:
  (tl;dr a magas láz fokozza a szervezet oxigénigényét, és a magas láz nem segít az immunrendszernek legyőzni a fertőzést)

  TREATMENT OF FEVER AND HYPERTHERMIA
  Elevated core temperature, whether fever or hyperthermia, increases the demand for oxygen and can aggravate preexisting cardiac or pulmonary insufficiency. For every increase of one degree above 37°C, there is a 13 percent increase in O2 consumption. In addition, elevated temperature can induce mental changes in patients with organic brain disease. Although a rapid reduction in elevated core temperature due to hyperthermia is mandatory, treatment of fever is often a debated issue.

  Decision to treat fever — The vast majority of fevers are associated with self-limited infections, most commonly of a viral origin, where the cause of the fever is easily identified. The decision to reduce fever with antipyretics assumes that there is no diagnostic benefit of allowing the fever to persist. However, there are rare clinical situations in which observation of the pattern of fever can be helpful diagnostically. As an example, the daily highs and lows of normal temperature are exaggerated in most fevers, but these fluctuations may be reversed in typhoid fever and disseminated tuberculosis. Temperature-pulse dissociation (relative bradycardia) is seen in typhoid fever, brucellosis, leptospirosis, some drug-induced fevers, and factitious fever. In healthy subjects, the temperature-pulse relationship is linear with an increase in heart rate of 4.4 beats/minute for each 1°C (2.44 beats/minute for each 1°F) rise in core temperature [11]. Fever may not be present during infection in newborns, older adults, patients with chronic renal failure, and in patients taking corticosteroids; hypothermia, in fact, can occur. Hypothermia can also be observed in patients with septic shock.

  Some febrile diseases have characteristic patterns. Among these are malaria and cyclic neutropenia. However, most of the febrile illnesses that are thought to exhibit a specific time-related pattern (eg, Hodgkin lymphoma) are in fact, upon close examination, not reliable indicators or are of no diagnostic value. As an example, there is no periodicity of fever in patients with familial Mediterranean fever. (See "Clinical manifestations and diagnosis of familial Mediterranean fever".)

  There are many reports on the beneficial effect of elevated temperature (febrile range) in animals during infectious challenges [44]. In addition, in vitro cultures of animal or human cells at elevated temperature are supportive of a heightened immune response as well as increased bactericidal killing. However, there are no studies demonstrating that fever itself facilitates the recovery from infection or acts as an adjuvant to the immune system. In fact, peripheral prostaglandin E2 (PGE2) production is a potent immunosuppressant and, during influenza vaccination, treatment with a nonsteroidal antiinflammatory agent (NSAID) increases the anti-influenza antibody level [45]. Hence, treating fever and its symptoms does no harm and does not slow the resolution of common viral and bacterial infections.

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