Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- "hic" sound
Outros fatores diagnósticos
- duration <48 hours (typically benign hiccups)
- duration >48 hours (chronic hiccups)
- persistence during sleep
- associated features of underlying cause
- weight loss and malnutrition
Fatores de risco
- aerophagia, temperature changes, and emotional states
- diaphragmatic and phrenic nerve irritation
- vagus nerve irritation
- central nervous system disorders
- metabolic/electrolyte abnormalities
- toxins/drugs
- psychogenic disorders
- sedation or anesthesia
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
Investigações a serem consideradas
- CBC
- serum electrolytes
- BUN
- C-reactive protein and erythrocyte sedimentation rate
- liver function tests
- gamma glutamyl transpeptidase (gamma-GT)
- serum amylase
- toxicology screen
- arterial blood gas
- ECG
- chest x-ray
- pulmonary function tests
- CT abdomen
- endoscopy of the upper gastrointestinal tract
- CT or MRI head
- lumbar puncture
- otoscopy
- pharyngoscopy
Algoritmo de tratamento
benign hiccups
chronic hiccups
Colaboradores
Autores
Aminah Jatoi, MD
Professor of Oncology
Department of Oncology
Mayo Clinic
Rochester
MN
Declarações
AJ has received a grant review for Pfizer (money is paid to her institution) and research funding from AstraZeneca. AJ is on an advisory board for Meter Health and Novartis. AJ is an author of one reference cited in this topic.
Agradecimentos
Professor Aminah Jatoi would like to gratefully acknowledge Professor Peter Kranke, Dr Yvonne Jelting, and Dr Thomas M. Metterlein, previous contributors to this topic.
Declarações
PK is an author of a reference cited in this topic. YJ and TMM declare that they have no competing interests.
Revisores
Andy Smith, BM, BS, MRCP, FRCA
Consultant Anaesthetist and Associate Director of Research and Development
Director
Lancaster Patient Safety Research Unit
Royal Lancaster Infirmary
Lancaster
UK
Declarações
AS declares that he has no competing interests.
Stefan K. Burgdorf, MD
Registrar
Department of Surgical Gastroenterology
Herlev Hospital
University of Copenhagen
Denmark
Declarações
SKB declares that he has no competing interests.
Howard Smith, MD, FACP
Academic Director of Pain Management
Associate Professor of Anesthesiology
Department of Anesthesiology
Albany Medical College
Albany
NY
Declarações
HS is an author of a reference cited in this topic.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Lewis JH. Hiccups: causes and cures. J Clin Gastroenterol. 1985 Dec;7(6):539-52. Resumo
Wagner MS, Stapczynski JS. Persistent hiccups. Ann Emerg Med. 1982 Jan;11(1):24-6. Resumo
Rousseau P. Hiccups. South Med J. 1995 Feb;88(2):175-81. Resumo
Moretto EN, Wee B, Wiffen PJ, et al. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD008768.Texto completo Resumo
Zhu LL, Wang WX, Guo XG. Acupuncture for hiccups after stroke: a systematic review. Chin J Evid Based Med. 2011;11:325-8.
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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