Hyperthermia: is it an ominous sign after cardiac arrest?
OBJECTIVE
To clarify the clinical characteristics of hyperthermia at an early stage after resuscitation from cardiac arrest (CA).


METHODS
We reviewed the medical records of 43 adult patients with non-traumatic out-of-hospital CA, who survived for longer than 24 h after admission to our intensive care unit (ICU) between January, 1995, and December, 1998. The patients were divided into two groups: a clinical brain death (CBD) group (n=23) and a non-CBD group (n=20), and various factors relating to hyperthermia were compared between the two groups.


RESULTS
The mean value of peak axillary temperatures within 72 h of admission was 39.8+/-0.9 degrees C for the CBD group, which was significantly greater than 38.3+/-0.6 degrees C for the non-CBD group (P<0.0001). The time of occurrence of the peak axillary temperature was at 19+/-16 h of admission in the CBD group and 20+/-18 h in the non-CBD group (not significantly different). There were no significant differences in risk factors relating to the occurrence of hyperthermia between the two groups, except for the number of patients who received epinephrine at ICU. In 23 patients with a peak axillary temperature of > or =39 degrees C during the first 72 h of hospitalization, brain death was diagnosed in 20 patients, whereas only 3 of 20 patients having a peak axillary temperature of <39 degrees C developed brain death (odds ratio, 37.8; 95% confidence interval, 6.72-212.2).


CONCLUSIONS
Hyperthermia at an early stage after resuscitation from CA may be associated with the outcome of brain death.
Takasu
A
A
Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. atakasu@me.ndmc.ac.jp
Saitoh
D
D
Kaneko
N
N
Sakamoto
T
T
Okada
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature / Q000502:physiology; D001926:Brain Death / Q000503:physiopathology; D002140:California / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005260:Female; D005334:Fever / Q000150:complications* / Q000401:mortality*; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors